Prairiecare

Primary specialty

Psychiatric HospitalTaxonomy code 283Q00000X

License

26-3715906 Issued in MN

Legal business name

PRAIRIECARE

Practice address

12915 63Rd Ave N
Maple Grove, MN 55369-6001

Phone

(952) 826-8405

NPI assigned

Oct 12, 2011

Organization subpart

No

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

Authorized official

Name

Joel Oberstar, M.D.

Title

Ceo

Phone

(763) 383-5800

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1318377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318377600000",
    "number": "1629353495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12915 63RD AVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553696001",
            "telephone_number": "952-826-8405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12915 63RD AVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553696001",
            "telephone_number": "952-826-8405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIECARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-12",
        "last_updated": "2011-10-12",
        "status": "A",
        "authorized_official_last_name": "OBERSTAR",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "763-383-5800",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "MN",
            "license": "26-3715906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Marie Poppe Grabinger, MS, CCC-SLP
• Heather Porter, PT
• Christine Nicole Poska, PA-C
• Lynn M Powers, PHD
• Prairie River Home Care
• Preferred Home Care Services Inc.
• Premise Health of Minnesota Medical P C
• Prestige Homecare LLC
• Andrea Price, PT
• Roberta Van Amber Prigge

• Psychiatric Hospital in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Psychiatric Hospital in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.