Healthcare Provider Details

I. General information

NPI: 1942313283
Provider Name (Legal Business Name): PRAIRIE RIDGE VILLAGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 02/16/2026
Certification Date: 02/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 4TH AVE S
GLASGOW MT
59230-2434
US

IV. Provider business mailing address

521 4TH AVE S
GLASGOW MT
59230-2434
US

V. Phone/Fax

Practice location:
  • Phone: 406-228-2208
  • Fax: 406-228-4208
Mailing address:
  • Phone: 406-228-2208
  • Fax: 406-228-4208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: AMBER LEE SWINDLER
Title or Position: DIRECTOR
Credential:
Phone: 406-230-2459