- Enrollment id
- O20161104000028
- Enrollment state
- AR
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1760939276
- Multiple npi flag
- N
- Ccn
- 041573
- Associate id
- 9830477322
- Organization name
- EH HOME HEALTH OF EAST TEXAS, LLC
- Doing business as name
- ENHABIT HOSPICE
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 128 N WASHINGTON
- City
- MAGNOLIA
- State
- AR
- Zip code
- 717532856