NPI 1578808663

Prairie Community Services

Organisation Mental Illness Community Based Residential Treatment Facility Duluth, MN

Practice location

Address: 1610 E 1st St, Duluth, MN 55812-1650
Phone: (218) 724-2945
Mailing address: 801 Nevada Ave STE 100, Morris, MN 56267-1874

Authorised official

Name: Sherry L Wagner
Title: Cfo
Phone: (320) 589-4919

Registered specialties (2)

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X Licence FBL-21674-37286 (MN)

Other Community Based Residential Treatment Facility, Mental Illness providers in Minnesota →

Mental Illness Community Based Residential Treatment Facility

Residential Treatment Facilities Taxonomy 320800000X Licence 1060122-1-RMI (MN)

Registry record

NPI: 1578808663
Entity type: Organization
NPI issued: 30 Nov 2012
Record last updated: 24 Jul 2013

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.