- Enrollment id
- O20050809000226
- Enrollment state
- KS
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1578651030
- Multiple npi flag
- N
- Ccn
- 171539
- Associate id
- 7517995012
- Organization name
- MITCHELL COUNTY HOSPITAL HEALTH SYSTEMS
- Doing business as name
- SOLOMON VALLEY HOSPICE
- Organization type structure
- OTHER
- Organization other type text
- COUNTY OWNED
- Proprietary nonprofit
- N
- Address line 1
- 400 W 8TH ST
- City
- BELOIT
- State
- KS
- Zip code
- 674201605