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PRAIRIE COMMUNITY SERVICES

Intermediate Care Facility, Mentally Retarded

(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.

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Contact Information

PRAIRIE COMMUNITY SERVICES
256 LAKE AVE N
SPICER, MN  56288-9512
 Phone: 320-589-3077
 Fax: 320-589-2543
 Website:
 

Specialty

 Taxonomy Code Specialty Code Provider Type

Intermediate Care Facility, Mentally Retarded

 315P00000X
Indicates primary specialty

NPI Profile & details for PRAIRIE COMMUNITY SERVICES

NPI # 1467530501
LBN Legal business name PRAIRIE COMMUNITY SERVICES
Authorized official SHERRY WAGNER - (CFO)
Entity Organization
Organization subpart 1 Yes
Enumeration date 11/02/2006
Last updated 03/18/2011 - About 15 years ago
Identifiers
MN License # 808004-1-RS
MN Medicaid 107522500
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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