PRAIRIECARE NPI 1629353495

NPI Information

  • NPI: 1629353495
  • Provider Name: PRAIRIECARE
  • Classification: Psychiatric Hospital - 283Q00000X
  • Entity Type: Organization
  • CLIA Number: 24D2108896
  • Address: 12915 63RD AVE N
    MAPLE GROVE, MN
    ZIP 55369
  • Phone: (952) 826-8405

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NPI Details

PRAIRIECARE is a psychiatric hospital in Maple Grove, MN. The provider is an organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. PRAIRIECARE NPI is 1629353495. The provider is registered as an organization entity type.

The provider's business location address is:

12915 63RD AVE N
MAPLE GROVE, MN
ZIP 55369-001
Phone: (952) 826-8405

The provider's authorized official is Joel Oberstar .
The authorized official title is Ceo and has the following contact phone number (763) 383-5800.

The CLIA number assigned to this NPI record is 24D2108896 - other - mental health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/12/2011 and was last updated on 10/12/2011.

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
1283Q00000XPsychiatric Hospital26-3715906MINNESOTAYes

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: 11/21/2025

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