- Enrollment id
- O20101018000156
- Enrollment state
- MN
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1427050582
- Multiple npi flag
- N
- Ccn
- 247103
- Associate id
- 1355251315
- Organization name
- KITTSON MEMORIAL HOSPITAL ASSOCIATION
- Doing business as name
- KITTSON HEALTHCARE
- Incorporation date
- 1922-10-01
- Incorporation state
- MN
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 1010 S BIRCH AVE
- City
- HALLOCK
- State
- MN
- Zip code
- 567284215
- Practice location type
- HHA BRANCH