NPIMap

Organization Active NPI

Prairie Community Services

  • Mental Illness Intermediate Care Facility
  • Morris, MN
National Provider Identifier
1164591095
Registry record updated Mar 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Intermediate Care FacilityTaxonomy code 310500000X
License
801045-1-RS Issued in MN
Legal business name
PRAIRIE COMMUNITY SERVICES
Practice address
801 Nevada Ave
Morris, MN 56267-1865
Phone
(320) 589-3077
Fax
(320) 589-2543
NPI assigned
Nov 7, 2006
Organization subpart
Yes
Parent organization
ST. FRANCIS HEALTH SERVICES OF MORRIS, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 18, 2011

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

Authorized official

Name
Sherry Wagner
Title
Cfo
Phone
(320) 589-4902

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Intermediate Care Facility 310500000X 801045-1-RS MN Primary

Addresses

Primary practice location

801 Nevada Ave
Morris, MN 56267-1865

Mailing address

801 Nevada Ave
Morris, MN 56267-1865
Phone (320) 589-3077

Other identifiers 1

IdentifierTypeStateIssuer
382045900MedicaidMN

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

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300406400000",
    "number": "1164591095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 NEVADA AVE",
            "city": "MORRIS",
            "state": "MN",
            "postal_code": "562671865",
            "telephone_number": "320-589-3077",
            "fax_number": "320-589-2543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 NEVADA AVE",
            "city": "MORRIS",
            "state": "MN",
            "postal_code": "562671865",
            "telephone_number": "320-589-3077",
            "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": "2006-11-07",
        "last_updated": "2011-03-18",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "320-589-4902"
    },
    "taxonomies": [
        {
            "code": "310500000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Mental Illness",
            "state": "MN",
            "license": "801045-1-RS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "382045900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Mar 18, 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.