# PRAIRIE MANOR, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Prairie Manor Nursing Home
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891778981
- **Authorized official:** MS. SANDRA BOOK (ADMINISTRATOR)
- **Authorized official phone:** (337) 599-2031

## Contact information

- **Practice address:** 1050 EDWIN ELLIOTT DR., PINE PRAIRIE, LA 70576
- **Practice address phone:** (337) 599-2031
- **Practice address fax:** (337) 599-2548
- **Mailing address:** PO BOX 500, 1050 EDWIN ELLIOT DR., PINE PRAIRIE, LA 70576-0500
- **Mailing address phone:** (337) 599-2031
- **Mailing address fax:** (337) 599-2548

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 452 | LA | Yes |
| 332BP3500X | Parenteral & Enteral Nutrition Supplies (DME) | — | — | — |

## Other

- **Enumeration date:** 11/22/2005
- **Last updated:** 12/10/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 19E379 | — | LA |