- Enrollment id
- O20221111002386
- Enrollment state
- TX
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1669125183
- Multiple npi flag
- N
- Ccn
- A91639
- Associate id
- 4284001710
- Organization name
- BREEZE HOSPICE LLC
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 3939 US HIGHWAY 80 E
- Address line 2
- SUITE 239B
- City
- MESQUITE
- State
- TX
- Zip code
- 751503359