NPI 1366681918

Prairie St. John's, LLC

Organisation Substance Abuse Rehabilitation Facility Fargo, ND

Practice location

Address: 510 4th St. South, Fargo, ND 58103
Phone: (401) 478-7517
Fax: (701) 478-7524

Authorised official

Name: Thomas Eide
Title: Cfo
Phone: (701) 476-7200

Registered specialties

Substance Abuse Rehabilitation Facility Primary

Residential Treatment Facilities Taxonomy 324500000X Licence 597-1-1-08A (ND)

Other Substance Abuse Rehabilitation Facility providers in North Dakota →

Registry record

NPI: 1366681918
Entity type: Organization
NPI issued: 5 Feb 2009
Record last updated: 5 Feb 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.