Organization
ETHOS PRAIRIE, LLC
Active
Other names
The Prairie Recovery Center
Organization subpart
No
Provider details
NPI number
Authorized official
JILLIAN SNOW (ADMINISTRATOR)
(832) 436-4260
Entity
Organization
Contact information
Practice address
5808 WAGNER RD, ROUND TOP, TX 78954-5075
(979) 836-4975
Mailing address
5808 WAGNER RD, ROUND TOP, TX 78954-5075
(979) 836-4975
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
10/08/2019
Last updated
05/12/2024
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