- Enrollment id
- O20160226001597
- Enrollment state
- TX
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1992103980
- Multiple npi flag
- N
- Ccn
- 741771
- Associate id
- 5193020253
- Organization name
- MESQUITE HOSPICE INC.
- Doing business as name
- BRIDGELIGHT HOSPICE CARE
- Incorporation date
- 2014-06-16
- Incorporation state
- TX
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 3132 W MILLER RD
- Address line 2
- STE C
- City
- GARLAND
- State
- TX
- Zip code
- 750416108