Organization
PRAIRIE LEARNING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN KOCH (FINANCE MANAGER)
(701) 597-3419
Entity
Organization
Contact information
Practice address
7785 SAINT GERTRUDE AVE, RALEIGH, ND 58564-4103
(701) 597-3479
Mailing address
7785 SAINT GERTRUDE AVE, RALEIGH, ND 58564-4103
(701) 597-3479
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50605
—
ND
Enumeration date
10/25/2006
Last updated
08/22/2020
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