PRAIRIE RIDGE INTEGRATED HEALTH CARE (NPI# 1043753056) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043753056 |
| Entity Type | Organization |
| Organization Name | PRAIRIE RIDGE INTEGRATED HEALTH CARE |
| Other Organization Name | ADDICTION SERVICES |
| Practice Address |
320 N Eisenhower Ave Mason City IA 50401-1521 |
| Practice Telephone | 6414242391 |
| Mailing Telephone | 6414242391 |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2016-11-22 |
| Authorized Official Name | JEREMY BAKER (CLINICIAN) |
| Authorized Official Telephone | 6415308055 |
| Authorized Official Credential | TCADC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Addiction Services | Former Legal Business Name - Organization |
| Street Address |
320 N EISENHOWER AVE |
| City | MASON CITY |
| State | IA |
| Zip Code | 50401-1521 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508979857 | Lisa Ann Bailey | Social Worker | 320 N Eisenhower Ave, Mason City, IA 50402-1338 | 2006-08-17 |
| 1437759289 | Valerie Michelle Linderman | Counselor | 320 N Eisenhower Ave, Mason City, IA 50401-1521 | 2020-10-30 |
| 1093323693 | Anthony Jennings | Counselor | 320 N Eisenhower Ave, Mason City, IA 50401-1521 | 2020-07-20 |
| 1144869157 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 320 N Eisenhower Ave, Mason City, IA 50401-1521 | 2019-12-23 |
| 1881238244 | Kimberly Jo Smith | Counselor | 320 N Eisenhower Ave, Mason City, IA 50401-1521 | 2019-10-29 |
| 1518509264 | Sabheen Soomro | Counselor | 320 N Eisenhower Ave, Mason City, IA 50401-1521 | 2019-10-15 |
| 1124671110 | Kelsey Marie Mceniry | Registered Nurse | 320 N Eisenhower Ave, Mason City, IA 50401-1521 | 2019-07-19 |
| 1992364095 | Nancy Kay Halford | Registered Nurse | 320 N Eisenhower Ave, Mason City, IA 50401-1521 | 2019-06-12 |
| 1568924066 | Linda Alice Woolery | Counselor | 320 N Eisenhower Ave, Mason City, IA 50401-1521 | 2019-04-03 |
| 1053894949 | Jennifer Lynn Gehrls | Counselor | 320 N Eisenhower Ave, Mason City, IA 50401-1521 | 2018-09-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912544123 | Handicap Village | Intermediate Care Facility, Mentally Retarded | 1140 Limestone St, Mason City, IA 50401 | 2019-12-06 |
| 1548829989 | Debra Lynn Perzynski | Counselor | 103 E State St Suite 301, Brick and Tile Building, Mason City, IA 50401 | 2019-06-10 |
| 1851858617 | Four Oaks Family and Children's Services | Psychiatric Residential Treatment Facility | 80 North Eisenhower Ave, Mason City, IA 50401 | 2019-02-27 |
| 1578055521 | Alex Jon Uhlenhopp | Optometrist | 422 S Pierce Ave Ste 1, Mason City, IA 50401 | 2018-06-05 |
| 1538672985 | Bonnie Jean Burnett | Hearing Instrument Specialist | 704 16th St. Ne, Mason City, IA 50401 | 2017-11-08 |
| 1639691009 | Jeremy Baker | Counselor | 320 N Eisenhower Avenue, Mason City, IA 50401 | 2017-07-07 |
| 1437689940 | Medi-dent, Inc. | Psychiatry & Neurology | 1050 15th St. S.w., Suite 2, Mason City, IA 50401 | 2017-06-18 |
| 1922485283 | Jamie Lynn Heard | Social Worker | 50 N. Eisenhower Ave., Mason City, IA 50401 | 2015-05-06 |
| 1558756999 | Tyler Borchardt | Specialist/Technologist | 640 South Indiana Avenue, Mason City, IA 50401 | 2015-04-02 |
| 1811339203 | Siddiq A. Khan | General Practice | 520 S. Pierce Ave. Suite 150, Mason City, IA 50401 | 2013-07-25 |
| Find all providers in zip 50401 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | 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. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275032443 | Morgan P Foley | Substance Abuse Rehabilitation Facility | 2030 Keokuk St, Iowa City, IA 52240-4456 | 2018-02-02 |
| 1629525308 | St. Gregory Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 1985 Ne 51st Pl, Des Moines, IA 50313-2517 | 2016-09-09 |
| 1477974244 | House of Mercy | Substance Abuse Rehabilitation Facility | 511 E 21st St S, Newton, IA 50208-5104 | 2013-12-23 |
| 1750511143 | St Gregory Centers, Inc | Substance Abuse Rehabilitation Facility | 5875 Fleur Dr, Des Moines, IA 50321-2883 | 2009-07-20 |
| 1568609360 | The Abbey | Substance Abuse Rehabilitation Facility | 1401 Central Ave, Bettendorf, IA 52722-6034 | 2009-01-15 |
| 1386810646 | Alcohol & Drug Dependency Services | Substance Abuse Rehabilitation Facility | 928 Main St, Keokuk, IA 52632-4655 | 2008-05-06 |
| 1043486400 | Alcohol & Drug Dependency Services | Substance Abuse Rehabilitation Facility | 304 Highway 61 N, Wapello, IA 52653-1243 | 2008-05-06 |
| 1174723118 | Fort Dodge Ywca Women's Halfway House | Substance Abuse Rehabilitation Facility | 826 1st Ave N, Fort Dodge, IA 50501-3906 | 2007-07-18 |
| 1871641159 | Clearview Recovery, Inc. | Substance Abuse Rehabilitation Facility | 501 N Sherman St, Prairie City, IA 50228-8666 | 2007-01-05 |
| 1801952205 | Resolutions Substance Abuse Services | Substance Abuse Rehabilitation Facility | 220 Lafayette St, Iowa City, IA 52240-1746 | 2006-12-29 |
| Find all providers with the same taxonomy | ||||
| City | MASON CITY |
| Zip Code | 50401 |
Please comment or provide details below to improve the information on PRAIRIE RIDGE INTEGRATED HEALTH CARE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.