# PRAIRIE LIVING CENTER, L.P.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Prairie House Living Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447286356
- **Authorized official:** MR. PETER J LICARI (PRESIDENT OF GENERAL PARTNER)
- **Authorized official phone:** (215) 441-7700

## Contact information

- **Practice address:** 1301 MESA DRIVE, PLAINVIEW, TX 79072
- **Practice address phone:** (806) 293-4855
- **Practice address fax:** (806) 293-2804
- **Mailing address:** 200 DRYDEN ROAD, SUITE 2000, DRESHER, PA 19025-1048
- **Mailing address phone:** (215) 441-7700
- **Mailing address fax:** (215) 441-4255

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 115199 | TX | Yes |
| 332BN1400X | Nursing Facility Supplies (DME) | 118925 | TX | — |
| 332BP3500X | Parenteral & Enteral Nutrition Supplies (DME) | 118925 | TX | — |

## Other

- **Enumeration date:** 06/23/2006
- **Last updated:** 09/02/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001013627 | — | TX |
| 05 | — | 021947901 | — | TX |