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PRAIRIE COMMUNITY SERVICES

Intermediate Care Facility, Mentally Retarded

Spicer, Minnesota

Provider NPI: 1467530501

Organization Information:
Organization Name:  PRAIRIE COMMUNITY SERVICES


Practice Location:
256 LAKE AVE N  SPICER, MN 56288 US
Tel: 320-589-3077  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y315P00000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mentally Retarded
MN808004-1-RS

Other Provider Identifiers:

IssuerNumberStateType
107522500MN05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




MENTALLY RETARDED JOBS MN - Page 1



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