- Enrollment id
- O20210910000442
- Enrollment state
- TX
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1649853953
- Multiple npi flag
- N
- Ccn
- A91548
- Associate id
- 1850797259
- Organization name
- RELIEF HERO PALLIATIVE INC
- Doing business as name
- ETERNAL FAITH HOSPICE
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 300 JACKSON ST
- City
- RICHMOND
- State
- TX
- Zip code
- 774693109