- Enrollment id
- O20230203001165
- Enrollment state
- MN
- Provider type code
- 00-85
- Provider type text
- PART A PROVIDER - CRITICAL ACCESS HOSPITAL
- Npi
- 1326757154
- Multiple npi flag
- N
- Ccn
- 241365
- Associate id
- 1850761685
- Organization name
- CENTRACARE HEALTH - BENSON LLC
- Doing business as name
- CENTRACARE - BENSON
- Incorporation date
- 2023-01-01
- Incorporation state
- MN
- Organization type structure
- LLC
- Proprietary nonprofit
- N
- Address line 1
- 1815 WISCONSIN AVE
- City
- BENSON
- State
- MN
- Zip code
- 562151653
- Practice location type
- OTHER HOSPITAL PRACTICE LOCATION
- Location other type text
- CRITICAL ACCESS
- Subgroup - general
- N
- Subgroup - acute care
- N
- Subgroup - alcohol drug
- N
- Subgroup - childrens
- N
- Subgroup - long-term
- N
- Subgroup - psychiatric
- N
- Subgroup - rehabilitation
- N
- Subgroup - short-term
- N
- Subgroup - swing-bed approved
- N
- Subgroup - psychiatric unit
- N
- Subgroup - rehabilitation unit
- N
- Subgroup - specialty hospital
- N
- Subgroup - other
- N
- Reh conversion flag
- N