- Enrollment id
- O20170624000036
- Enrollment state
- CO
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1033122544
- Multiple npi flag
- N
- Ccn
- 067277
- Associate id
- 8729987219
- Organization name
- LINCOLN COMMUNITY HOSPITAL
- Doing business as name
- LINCOLN HEALTH HOME HEALTH
- Organization type structure
- OTHER
- Organization other type text
- COUNTY OWNED
- Proprietary nonprofit
- N
- Address line 1
- 111 6TH ST
- City
- HUGO
- State
- CO
- Zip code
- 808210248
- Practice location type
- HHA BRANCH