Organization
PRAIRIE ADULT CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN A EVANSON (PRESIDENT/DIRECTOR)
(952) 949-3126
Entity
Organization
Contact information
Practice address
16200 BERGER DR, EDEN PRAIRIE, MN 55347-2365
(952) 949-3126
Mailing address
6015 WINKER LN, PRIOR LAKE, MN 55372-8170
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
1062750
MN
Other
Enumeration date
03/15/2012
Last updated
03/15/2012
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