PRAIRIE COMMUNITY SERVICES NPI 1578808663

NPI Information

NPI: 1578808663
Provider Name: PRAIRIE COMMUNITY SERVICES

Doing Business As: FRESH START PCS

Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
1610 E 1ST ST
DULUTH, MN
ZIP 55812
Phone: (218) 724-2945
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PRAIRIE COMMUNITY SERVICES is a community based residential treatment facility mental illness in Duluth, MN. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. PRAIRIE COMMUNITY SERVICES NPI is 1578808663. The provider is registered as an organization entity type.
The provider Is Doing Business As Fresh Start Pcs.

The provider's business location address is:

1610 E 1ST ST
DULUTH, MN
ZIP 55812-650
Phone: (218) 724-2945

The provider's authorized official is Sherry L Wagner .
The authorized official title is Cfo and has the following contact phone number (320) 589-4919.

The enumeration date for this NPI number is 11/30/2012 and was last updated on 7/24/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320800000X	Community Based Residential Treatment Facility, Mental Illness		1060122-1-RMI	MINNESOTA	No
2	320800000X	Community Based Residential Treatment Facility, Mental Illness		FBL-21674-37286	MINNESOTA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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