FRESH START PCS – NPI #1578808663
Community Based Residential Treatment Facility, Mental Illness

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

FRESH START PCS is a community based residential treatment facility located in DULUTH, MN. NPPES has assigned the NPI number 1578808663 to FRESH START PCS on November 30, 2012. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “FRESH START PCS” is a dba name, the actual legal business name for this organization is PRAIRIE COMMUNITY SERVICES. The primary taxonomy selected by this provider is 320800000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Mental Illness.

The NPI profile was previously updated about 13 years ago on Jul 24, 2013. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for FRESH START PCS below.

NPI Profile for
PRAIRIE COMMUNITY SERVICES

NPI Number
1578808663
Enumeration Date

(more than 13 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PRAIRIE COMMUNITY SERVICES
Doing Business As (dba): FRESH START PCS
Primary location
1610 E 1ST ST
DULUTH, MN 55812-1650
Phone: (218) 724-2945 Fax:
Mailing address
801 NEVADA AVE STE 100
MORRIS, MN 56267-1874
Phone: (320) 589-2004 Fax: (320) 589-1270
Organization Subpart
Yes - FRESH START PCS is subpart of another organization.
Authorized Official
SHERRY WAGNER
CFO
Phone: (320) 589-4919
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320800000X
- Community Based Residential Treatment Facility, Mental Illness (Primary)
MN 1060122-1-RMI

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.