Organization
PRAIRIE INNOVATIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT L WETENKAMP (OWNER)
(605) 229-6850
Entity
Organization
Contact information
Practice address
902 S JAY ST, ABERDEEN, SD 57401-6150
(605) 229-6850
(605) 225-1417
Mailing address
PO BOX 887, ABERDEEN, SD 57402-0887
(605) 229-6850
(605) 225-1417
Taxonomy
Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
Primary
—
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11014231
SD DEPT OF SOCIAL SERVICE
SD
05
—
9560550
—
SD
Enumeration date
09/16/2006
Last updated
08/22/2020
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