- Enrollment id
- O20180910000439
- Enrollment state
- MN
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1386741684
- Multiple npi flag
- N
- Ccn
- 247111
- Associate id
- 9638080187
- Organization name
- MADISON HEALTHCARE SERVICES
- Doing business as name
- MADISON HOME HEALTH AGENCY
- Incorporation state
- MN
- Organization type structure
- LLC
- Proprietary nonprofit
- N
- Address line 1
- 900 2ND AVE
- City
- MADISON
- State
- MN
- Zip code
- 562561006
- Practice location type
- HHA BRANCH