- Enrollment id
- O20040105000091
- Enrollment state
- CO
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1730295593
- Multiple npi flag
- N
- Ccn
- 061552
- Associate id
- 8729987219
- Organization name
- LINCOLN COMMUNITY HOSPITAL
- Doing business as name
- LINCOLN HEALTH HOSPICE
- Organization type structure
- OTHER
- Organization other type text
- COUNTY OWNED
- Proprietary nonprofit
- N
- Address line 1
- 111 6TH ST
- City
- HUGO
- State
- CO
- Zip code
- 808212002