- Enrollment id
- O20080724000319
- Enrollment state
- CO
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1720086333
- Multiple npi flag
- N
- Ccn
- 067161
- Associate id
- 6305758830
- Organization name
- YUMA DISTRICT HOSPITAL
- Doing business as name
- YUMA DISTRICT HOSPITAL HOME HEALTH
- Organization type structure
- GOVERNMENT
- Proprietary nonprofit
- N
- Address line 1
- 1000 W 8TH AVE
- City
- YUMA
- State
- CO
- Zip code
- 807592641
- Practice location type
- HHA BRANCH