- Enrollment id
- O20230720002961
- Enrollment state
- TX
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1790447134
- Multiple npi flag
- N
- Ccn
- A91641
- Associate id
- 6709246879
- Organization name
- FORDGROVE HEALTHCARE LLC
- Doing business as name
- THE GROVE CARE CENTERS OF AMERICA
- Incorporation date
- 2020-12-07
- Incorporation state
- TX
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 4606 FM 1960 RD W
- Address line 2
- STE 610
- City
- HOUSTON
- State
- TX
- Zip code
- 770694600