Organization
PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES
Active
Other names
LAKE REGION HEALTHCARE
Organization subpart
No
Provider details
NPI number
Authorized official
KENT MATTSON (CEO)
(218) 736-8090
Entity
Organization
Contact information
Practice address
1411 HWY 79E, ELBOW LAKE, MN 56531-4605
(218) 685-7300
(218) 685-7296
Mailing address
1411 HWY 79E, ELBOW LAKE, MN 56531-4605
(218) 685-7300
(218) 685-7296
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
00154
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
241379
NORIDIAN MEDICARE
MN
01
—
24Z379
NORIDIAN MEDICARE SWINGBED
MN
01
—
C06639
WPS MEDICARE
MN
Enumeration date
11/16/2005
Last updated
08/19/2024
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