PRAIRIE ST. JOHN'S, LLC – NPI #1366681918
Substance Abuse 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.

PRAIRIE ST. JOHN'S, LLC is a substance abuse rehabilitation facility located in FARGO, ND. NPPES has assigned the NPI number 1366681918 to PRAIRIE ST. JOHN'S, LLC on February 05, 2009. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 324500000X from the Health Care Provider Taxonomy code set, which is classified as Substance Abuse Rehabilitation Facility.

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 PRAIRIE ST. JOHN'S, LLC below.

NPI Profile for
PRAIRIE ST. JOHN'S, LLC

NPI Number
1366681918
Enumeration Date

(more than 17 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 ST. JOHN'S, LLC
Primary location
510 4TH ST. SOUTH
FARGO, ND 58103
Phone: (401) 478-7517 Fax: (701) 478-7524
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
THOMAS EIDE
CFO
Phone: (701) 476-7200
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
324500000X
- Substance Abuse Rehabilitation Facility (Primary)
ND 597-1-1-08A

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.