- Enrollment id
- O20060314000172
- Enrollment state
- MN
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1053346825
- Multiple npi flag
- N
- Ccn
- 248028
- Associate id
- 5092619387
- Organization name
- SAINT ELIZABETHS HOSPITAL OF WABASHA INC
- Doing business as name
- GUNDERSEN ST ELIZABETH'S HOME CARE
- Incorporation date
- 1965-01-01
- Incorporation state
- MN
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 1200 GRANT BLVD W
- City
- WABASHA
- State
- MN
- Zip code
- 559811042