Prairie Bluffs Rehabilitation Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PRAIRIE BLUFFS REHABILITATION CENTER LLC

Practice address

10300 Hennepin Town Rd
Eden Prairie, MN 55347-5100

Phone

(507) 203-1001

NPI assigned

Mar 30, 2020

Organization subpart

No

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

Authorized official

Name

Joshua Legum

Title

Ceo

Phone

(507) 203-1001

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1585526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585526400000",
    "number": "1639707177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2361 NOSTRAND AVE STE 903",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112103953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 HENNEPIN TOWN RD",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553475100",
            "telephone_number": "507-203-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE BLUFFS REHABILITATION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-30",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A",
        "authorized_official_last_name": "LEGUM",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "507-203-1001"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dareya Pozdnyakov
• Prairie Adult Care, Inc.
• Prairie Bluffs Senior Living Operations LLC
• Prairie Bluffs Tcu, LLC
• Prairie Coaching LLC
• Prairie Dental Group
• Prairie Residence Care, LLC

• Skilled Nursing Facility in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Skilled Nursing Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2020; 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.