- Enrollment id
- O20130627000906
- Enrollment state
- MN
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1245579713
- Multiple npi flag
- N
- Ccn
- 245519
- Associate id
- 4587573613
- Organization name
- ALLINA HEALTH SYSTEM
- Doing business as name
- COURAGE KENNY REHABILITATION INSTITUTE TRP
- Incorporation date
- 1983-09-28
- Incorporation state
- MN
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Nursing home provider name
- COURAGE KENNY REHABILITATION INSTITUTES TRP
- Address line 1
- 3915 GOLDEN VALLEY RD
- City
- GOLDEN VALLEY
- State
- MN
- Zip code
- 554224249