PRAIRIE COMMUNITY SERVICES NPI 1124336862

NPI Information

NPI: 1124336862
Provider Name: PRAIRIE COMMUNITY SERVICES

Other Name: BRENTWOOD PCS

Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
801 NEVADA AVE STE 100
MORRIS, MN
ZIP 56267
Phone: (320) 589-2004
Get Directions

PRAIRIE COMMUNITY SERVICES is a community based residential treatment facility mental illness in Morris, 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 1124336862. The provider is registered as an organization entity type.
The provider Other Name Is Brentwood Pcs.

The provider's business location address is:

801 NEVADA AVE STE 100
MORRIS, MN
ZIP 56267-874
Phone: (320) 589-2004
Fax: (320) 589-2543

The provider's authorized official is Sherry Wagner .
The authorized official title is Assist Director Of Finance and has the following contact phone number (320) 589-4902.

The enumeration date for this NPI number is 9/15/2010 and was last updated on 4/19/2011.

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	251S00000X	Community/Behavioral Health		1056816	MINNESOTA	No
2	320800000X	Community Based Residential Treatment Facility, Mental Illness		1056816	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1124336862	MEDICAID	MINNESOTA

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: 5/5/2024

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