# PRAIRIE ACRES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Friona Heritage Estates
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912982083
- **Authorized official:** NICHOLE M. BRISTER LNFA (ADMINISTRATOR)
- **Authorized official phone:** (806) 250-3922

## Contact information

- **Practice address:** 201 E. 15TH STREET, FRIONA, TX 79035
- **Practice address phone:** (806) 250-3922
- **Practice address fax:** (806) 250-2132
- **Mailing address:** 201 E. 15TH STREET, FRIONA, TX 79035
- **Mailing address phone:** (806) 250-3922
- **Mailing address fax:** (806) 250-2132

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | 107250 | TX | — |
| 310400000X | Assisted Living Facility | 126276 | TX | — |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 111644 | TX | — |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 125044 | TX | Yes |

## Other

- **Enumeration date:** 12/13/2005
- **Last updated:** 04/09/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000509501 | — | TX |
| 05 | — | 001001908 | — | TX |
| 05 | — | 021936201 | — | TX |
| 01 | — | 1280270001 | MEDICARE DMERC | — |