- Enrollment id
- O20050121000073
- Enrollment state
- MN
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1184661894
- Multiple npi flag
- Y
- Ccn
- 248091
- Associate id
- 4587573613
- Organization name
- ALLINA HEALTH SYSTEM
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 2925 CHICAGO AVE
- City
- MINNEAPOLIS
- State
- MN
- Zip code
- 554071321