Prairie St. John's, LLC
NPI #1366681918 in Fargo, North Dakota
Provider Information
- NPI Number
- 1366681918
- Entity Type
- Organization
- Organization Name
- Prairie St. John's, LLC
- Primary Specialty
- Substance Abuse Rehabilitation Facility
- Enumeration Date
- Feb 5, 2009
- Last Updated
- Feb 5, 2009
Practice Location
- Address
- 510 4TH ST. SOUTH
- City
- Fargo
- State
- North Dakota
- ZIP Code
- 58103
- Phone
- (401) 478-7517
Authorized Official
- Name
- MR. THOMAS EIDE
- Title
- CFO
- Phone
- (701) 476-7200
Specialties & Taxonomy Codes
| Specialty |
|---|
| Substance Abuse Rehabilitation Facility |
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