PRAIRIE LAKES YOUTH PROGRAMS BOYS GROUP HOME (NPI# 1679750426) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679750426 |
| Entity Type | Organization |
| Organization Name | PRAIRIE LAKES YOUTH PROGRAMS BOYS GROUP HOME |
| Practice Address |
1013 Lakeland Dr Ne Willmar MN 56201-2114 |
| Mailing Address |
1804 Civic Center Dr Po Box 902 Willmar MN 56201-9446 |
| Practice Telephone | 3202356895 |
| Practice Fax Number | 3202313818 |
| Mailing Telephone | 3202350975 |
| Mailing Fax Number | 3202147067 |
| Enumeration Date | 2008-01-23 |
| Last Update Date | 2008-01-23 |
| Authorized Official Name | JOYCE K. MCGILLIVRAY (ACCOUNTS MANAGER) |
| Authorized Official Telephone | 3202350975 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
1049804-1-CRF | MN | Residential Treatment Facilities |
| Street Address |
1013 LAKELAND DR NE |
| City | WILLMAR |
| State | MN |
| Zip Code | 56201-2114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730793472 | Sarah Erickson | Counselor | 2120 60th Ave N.w., Willmar, MN 56201 | 2020-09-01 |
| 1417560681 | Amy Engle | Nurse Practitioner | 1125 Se 8th Street, Willmar, MN 56201 | 2020-08-28 |
| 1154856524 | Mude Transportation Inc | Non-emergency Medical Transport (VAN) | 1712 Monongalia Ave Sw Ap1, Willmar, MN 56201 | 2017-04-24 |
| 1285025874 | Jill Fellows | Occupational Therapist | 611 5th St. Sw, Willmar, MN 56201 | 2015-02-18 |
| 1700294881 | Brenda Wiese | Counselor | 1617 Hwy 12 E, Suite 230, Willmar, MN 56201 | 2014-08-01 |
| 1275955932 | Courtney Regnier | Marriage & Family Therapist | 2320 E Hwy 12 Ste 2, Willmar, MN 56201 | 2014-01-15 |
| 1568732402 | Pamela Jean Kubesh | Social Worker | 328 Sw 3rd Street, Willmar, MN 56201 | 2012-01-10 |
| 1699931824 | Community Behavioral Health Hospital-willmar | Psychiatric Hospital | 1208 Olena Ave Se, Willmar, MN 56201 | 2008-08-07 |
| 1700053345 | Nathan Schrick | Marriage & Family Therapist | 513 Sw 5th Street, Box 1810, Willmar, MN 56201 | 2008-05-13 |
| 1831381680 | Joan M Blonigan Christianson | Chiropractor | 1101 S 1st Street, Willmar, MN 56201 | 2007-08-15 |
| Find all providers in zip 56201 | ||||
| Taxonomy Code | 3245S0500X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| Specialization | Substance Abuse Treatment, Children |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831376680 | Prairie Lakes Youth Programs Girls Group Home | Substance Abuse Rehabilitation Facility | 822 Park Ave, Willmar, MN 56201-2568 | 2008-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780020925 | St. Cloud Hospital | Substance Abuse Rehabilitation Facility | 1572 Co Rd 134, St. Cloud, MN 56303-0346 | 2013-05-15 |
| 1558652925 | Tapestry | Substance Abuse Rehabilitation Facility | 135 Colorado St E, Saint Paul, MN 55107-2244 | 2011-04-20 |
| 1841441854 | Lutheran Social Service of Minnesota | Substance Abuse Rehabilitation Facility | 39413 120th St Sw, East Grand Forks, MN 56721-9121 | 2008-10-08 |
| 1922275148 | Temporary Living Center | Substance Abuse Rehabilitation Facility | 7170 Bryant Lake Dr, Eden Prairie, MN 55344-3502 | 2008-05-15 |
| 1225202625 | Redlake Chemical Health Program Group Home | Substance Abuse Rehabilitation Facility | 15797 Main Avenue, Redlake, MN 56671 | 2008-04-16 |
| 1124212873 | Jacy 2, LLC | Substance Abuse Rehabilitation Facility | 319 Csah #20, Litchfield, MN 55355 | 2007-09-05 |
| 1588855878 | Lutheran Social Service of Minnesota | Substance Abuse Rehabilitation Facility | 28579 Us Highway 10, Springhill Group Home, Detroit Lakes, MN 56501-7308 | 2007-08-05 |
| 1376733659 | Lutheran Social Service of Minnesota | Substance Abuse Rehabilitation Facility | 820 Eickhof Blvd, Kairos House, Crookston, MN 56716-2600 | 2007-08-01 |
| 1275731317 | Minnesota Correctional Facility -togo | Substance Abuse Rehabilitation Facility | 62741 County Road 551, Togo, MN 55723-4509 | 2007-07-10 |
| 1811193188 | Nexus | Substance Abuse Rehabilitation Facility | 100 Crosier Dr, Suite 1, Onamia, MN 56359-4512 | 2007-06-25 |
| Find all providers with the same taxonomy | ||||
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| 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.