Organization
PRAIRIE LAKES YOUTH PROGRAMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARIN BALKEN (EXECUTIVE DIRECTOR)
(320) 231-1729
Entity
Organization
Contact information
Practice address
1808 CIVIC CENTER DR, WILLMAR, MN 56201-9446
(320) 231-1729
(321) 231-1166
Mailing address
1808 CIVIC CENTER DR, PO BOX 894, WILLMAR, MN 56201-9446
(320) 231-1729
(321) 231-1166
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
1036941-1-CRF
MN
Other
Enumeration date
12/11/2007
Last updated
12/11/2007
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