Prairie St Johns, NPI 1417901000
Psychiatric Hospital in Fargo, ND, US
NPI number: what is it?
The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...
| NPI | 1417901000 |
| NPI Entity Type | Organization |
| Provider Name |
Prairie St Johns
Former Legal Business Name |
| Enumeration Date | September 30, 2009 |
| Last Update Date | September 30, 2009 |
| Provider Location Address | 510 4th St S, Fargo, ND, US |
| Provider Mailing Address | 510 4th St S, Fargo, ND, US, 581031914 |
| Is Sole Proprietor? | No |
Organization Official
| Official Name | MD Emmet M Kenney JR. |
| Official Position | CHIEF EXECUTIVE OFFICER |
| Phone | 701-476-7882 |
Primary Taxonomy
| Taxonomy Code | |
| Taxonomy Name | Psychiatric Hospital |
| Classification | |
| Group | |
| License No. | 5063A |
| License State | ND |
| Description | An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |
Secondary Taxonomies
| Taxonomy Code | Group | Classification | License No. | State | Primary? |
|---|---|---|---|---|---|
| 1567 | MN | No |
Other Identifiers
| Identifier | Identifier State | Identifier Issuer | Type/Code |
|---|---|---|---|
| 11778 | ND | MEDICAID | 05 |
| 99725100 | MN | MEDICAID | 05 |
| 099725100 | MN | MEDICAID | 05 |
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