NPIMap

Organization Active NPI

Prairie Community Services

  • Mental Illness Community Based Residential Treatment Facility
  • Morris, MN
National Provider Identifier
1124336862
Registry record updated Apr 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
1056816 Issued in MN
Legal business name
PRAIRIE COMMUNITY SERVICES
Practice address
801 Nevada Ave Ste 100
Morris, MN 56267-1874
Phone
(320) 589-2004
Fax
(320) 589-2543
NPI assigned
Sep 15, 2010
Organization subpart
Yes
Parent organization
ST. FRANCIS HEALTH SERVICES OF MORRIS, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 19, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sherry Wagner
Title
Assist Director of Finance
Phone
(320) 589-4902

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 1056816 MN
Mental Illness Community Based Residential Treatment Facility 320800000X 1056816 MN Primary

Addresses

Primary practice location

801 Nevada Ave Ste 100
Morris, MN 56267-1874

Mailing address

801 Nevada Ave Ste 100
Morris, MN 56267-1874
Phone (320) 589-2004

Other identifiers 1

IdentifierTypeStateIssuer
1124336862MedicaidMN

Other names 1

  • Brentwood PCS Other name

National Provider Directory

National Provider Directory
Tax ID family
Prairie Community Services18 organizations share this tax ID, including this one
Part of
St Francis Health Services of Morris Inc

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Locations

801 Nevada Ave
Ste 100
Morris, MN 56267
Phone (320) 589-2004

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1284508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303171200000",
    "number": "1124336862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 NEVADA AVE STE 100",
            "city": "MORRIS",
            "state": "MN",
            "postal_code": "562671874",
            "telephone_number": "320-589-2004",
            "fax_number": "320-589-2543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 NEVADA AVE STE 100",
            "city": "MORRIS",
            "state": "MN",
            "postal_code": "562671874",
            "telephone_number": "320-589-2004",
            "fax_number": "320-589-2543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE COMMUNITY SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. FRANCIS HEALTH SERVICES OF MORRIS, INC",
        "enumeration_date": "2010-09-15",
        "last_updated": "2011-04-19",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_title_or_position": "ASSIST DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "320-589-4902"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": "1056816",
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "MN",
            "license": "1056816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124336862",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brentwood PCS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Morris, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.