| NPI | 1316454424 |
|---|---|
| Doing Business As | PRAIRIE RIDGE |
| Entity Type | Organization |
| Authorized Contact | LARECE ANNETTE BARTUSEK Office Manager 641-243-7222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Enumeration Date | 2018-01-10 |
| Last Update Date | 2018-01-10 |