- Enrollment id
- O20130904000715
- Enrollment state
- TX
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1902142011
- Multiple npi flag
- N
- Ccn
- 741512
- Associate id
- 7517100902
- Organization name
- GIFT OF LIFE HOSPICE LLC
- Doing business as name
- ANGEL HANDS HOSPICE - TARRANT COUNTY
- Incorporation date
- 2012-12-12
- Incorporation state
- TX
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 1616 GATEWAY BLVD
- Address line 2
- SUITE F
- City
- RICHARDSON
- State
- TX
- Zip code
- 750803529