NPIMap

Organization Active NPI

Prairie Community Services Inc

Doing business as Brentwood

  • Mental Illness Community Based Residential Treatment Facility
  • Marshall, MN
National Provider Identifier
1740591270
Registry record updated Apr 7, 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 INC
Doing business as
Brentwood
Practice address
1012 Esther LN
Marshall, MN 56258-2293
Phone
(320) 589-3077
Fax
(320) 589-4955
NPI assigned
Jun 30, 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 7, 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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X 1056816 MN Primary

Addresses

Primary practice location

1012 Esther LN
Marshall, MN 56258-2293

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1740591270MedicaidMN

Other names 1

  • Brentwood Doing business as

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": "1277856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302134400000",
    "number": "1740591270",
    "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": "1012 ESTHER LN",
            "city": "MARSHALL",
            "state": "MN",
            "postal_code": "562582293",
            "telephone_number": "320-589-3077",
            "fax_number": "320-589-4955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE COMMUNITY SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. FRANCIS HEALTH SERVICES OF MORRIS, INC",
        "enumeration_date": "2010-06-30",
        "last_updated": "2011-04-07",
        "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": "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": "1740591270",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brentwood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marshall, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.