- Enrollment id
- O20190607002400
- Enrollment state
- TX
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1922575422
- Multiple npi flag
- N
- Ccn
- 971568
- Associate id
- 3476886383
- Organization name
- FORT BEND HOSPICE AND PALLIATIVE CARE LLC
- Incorporation date
- 2018-10-15
- Incorporation state
- TX
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 26717 WESTHEIMER PKWY
- Address line 2
- UNIT 103
- City
- KATY
- State
- TX
- Zip code
- 774948058