- Enrollment id
- O20030325000011
- Enrollment state
- MI
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1457459059
- Multiple npi flag
- N
- Ccn
- 231586
- Associate id
- 7416866611
- Organization name
- BARAGA COUNTY MEMORIAL HOSPITAL
- Doing business as name
- BARAGA COUNTY HOME CARE & HOSPICE
- Organization type structure
- GOVERNMENT
- Proprietary nonprofit
- N
- Address line 1
- 18341 US HIGHWAY 41
- Address line 2
- STE 1
- City
- LANSE
- State
- MI
- Zip code
- 499468024