| NPI | 1891031209 |
|---|---|
| Doing Business As | SAGE PRAIRIE |
| Entity Type | Organization |
| Authorized Contact | ANNE M PYLKAS CEO 612-435-7380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MN 52519) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 363AM0700X Physician Assistant, Medical (Licence: MN 12684) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2012-12-13 |
| Last Update Date | 2022-08-17 |