- Enrollment id
- O20130301000085
- Enrollment state
- TX
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1679823033
- Multiple npi flag
- N
- Ccn
- 741505
- Associate id
- 6901051747
- Organization name
- HARBOR HOSPICE OF WEST HOUSTON LP
- Incorporation date
- 2012-09-12
- Incorporation state
- TX
- Organization type structure
- OTHER
- Organization other type text
- LIMITED PARTNERHSIP
- Proprietary nonprofit
- P
- Address line 1
- 11980 KIRBY DR
- Address line 2
- STE 210
- City
- HOUSTON
- State
- TX
- Zip code
- 770454860