- Enrollment id
- O20120402000671
- Enrollment state
- SD
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1861574956
- Multiple npi flag
- N
- Ccn
- 437030
- Associate id
- 1052307105
- Organization name
- CITY OF BROOKINGS
- Doing business as name
- BROOKINGS HEALTH SYSTEM
- Organization type structure
- OTHER
- Organization other type text
- MUNICIPAL
- Proprietary nonprofit
- N
- Address line 1
- 300 22ND AVE
- City
- BROOKINGS
- State
- SD
- Zip code
- 570062480