Organization Name: | PRAIRIE COMMUNITY SERVICES |
NPI Number: | 1578808663 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SHERRY L WAGNER (CFO) |
Mailing Address: | 1610 E 1st St Duluth |
State: | MN US |
Postal Code: | 558121650 |
Phone Number: | 2187242945 |
Fax Number: | |
NPI Enumeration Date: | 11/30/2012 |
NPI Last Update Date: | 07/24/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320800000X |
License Number: | 1060122-1-RMI |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MN |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment Facility, Mental Illness |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |