| Organization Name: | CENTRACARE CLINIC LONG PRAIRIE |
| NPI Number: | 1538161146 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | THOMAS M FELDHEGE (TREASURER DIRECTOR OF FINANCE) |
| Mailing Address: | 24 9th St Se Centracare Clinic Long Prairie Long Prairie |
| State: | MN US |
| Postal Code: | 56347 |
| Phone Number: | 3207322131 |
| Fax Number: | |
| NPI Enumeration Date: | 08/12/2005 |
| NPI Last Update Date: | 02/21/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |