Summit Prairie Recovery Center

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

SUMMIT PRAIRIE RECOVERY CENTER

Practice address

7785 Saint Gertrude Ave
Raleigh, ND 58564-4103

Phone

(701) 597-3419

NPI assigned

Jun 23, 2020

Last updated

Jun 23, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Matthew Dalessandro

Title

Managing Partner

Phone

(732) 580-1732

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592870400000",
    "number": "1831715002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7785 SAINT GERTRUDE AVE",
            "city": "RALEIGH",
            "state": "ND",
            "postal_code": "585644103",
            "telephone_number": "701-597-3419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7785 SAINT GERTRUDE AVE",
            "city": "RALEIGH",
            "state": "ND",
            "postal_code": "585644103",
            "telephone_number": "701-597-3419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT PRAIRIE RECOVERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-23",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A",
        "authorized_official_last_name": "DALESSANDRO",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "732-580-1732"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prairie Learning Center
• Kayla Schelske
• Richelle Schmaltz
• Holly Lo Ann Steckler, LSW
• Shannon L Strating, LSW LICENSE NUMBER 2
• Deann Super
• Nicholle Terry, LMSW
• Alicia Elena Villarreal, MHP, LMSW
• Kelsey Wald
• Dan E. Wrolstad

• Substance Abuse Rehabilitation Facility in Raleigh, ND
• Providers in Raleigh, ND by specialty
• Substance Abuse Rehabilitation Facility in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.