Prairie St Johns
NPI #1417901000 in Fargo, North Dakota
Provider Information
- NPI Number
- 1417901000
- Entity Type
- Organization
- Organization Name
- Prairie St Johns
- Primary Specialty
- Psychiatric Hospital
- Enumeration Date
- May 19, 2006
- Last Updated
- May 22, 2008
Practice Location
- Address
- 510 4TH ST S
- City
- Fargo
- State
- North Dakota
- ZIP Code
- 58103-1914
- Phone
- (701) 476-7200
Authorized Official
- Name
- EMMET M KENNEY JR., MD
- Title
- CHIEF EXECUTIVE OFFICER
- Phone
- (701) 476-7882
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychiatric Hospital |
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