National Provider Identifier Database

PRAIRIE ST JOHNS LLC
Substance Abuse Disorder Rehabilitation Facility

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.


Contact Information

PRAIRIE ST. JOHN'S, LLC
510 4TH ST. SOUTH
FARGO, ND58103
Phone: 401-478-7517
Fax: 701-478-7524
Website:
Specialty Taxonomy Code
* Substance Abuse Disorder Rehabilitation Facility 324500000X

* Indicates primary specialty

NPI Profile & details for PRAIRIE ST. JOHN'S, LLC

NPI Number 1366681918
Legal business name
LBN
PRAIRIE ST. JOHN'S, LLC
Authorized official THOMAS EIDE - (CFO)
Entity Organization
Organization subpart No
Enumeration date 02/05/2009
Last updated 02/05/2009 - About 17 years ago
Sole proprietor1 Not specified
Identifiers
  • ND License #: 597-1-1-08A

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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