- Enrollment id
- O20050727000624
- Enrollment state
- MN
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1588742217
- Multiple npi flag
- N
- Ccn
- 247158
- Associate id
- 9830127356
- Organization name
- HENDRICKS COMMUNITY HOSPITAL ASSN & RETIREMENT HOME
- Incorporation date
- 1941-02-25
- Incorporation state
- MN
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 503 E LINCOLN ST
- City
- HENDRICKS
- State
- MN
- Zip code
- 561369598