- Enrollment id
- O20100310000013
- Enrollment state
- WI
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1396736831
- Multiple npi flag
- N
- Ccn
- 527085
- Associate id
- 1254347586
- Organization name
- CALUMET COUNTY
- Doing business as name
- CALUMET COUNTY HHC/HOSPICE AGENCY
- Incorporation date
- 1848-05-29
- Incorporation state
- WI
- Organization type structure
- GOVERNMENT
- Proprietary nonprofit
- N
- Address line 1
- 206 COURT ST
- City
- CHILTON
- State
- WI
- Zip code
- 530141198
- Practice location type
- HHA BRANCH