Healthcare Provider Details
I. General information
NPI: 1841904109
Provider Name (Legal Business Name): PRAIRIE VIEW SNF OPERATIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/11/2023
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
401 S 1ST AVE
WOONSOCKET SD
57385-2139
US
IV. Provider business mailing address
4601 NE 77TH AVE STE 300
VANCOUVER WA
98662-6736
US
V. Phone/Fax
- Phone: 605-796-4467
- Fax: 605-796-4497
- Phone: 360-837-0400
- Fax: 360-967-0022
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 227900000X |
| Taxonomy | Registered Respiratory Therapist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
YITZCHOK
YENOWITZ
Title or Position: AUTHORIZED REPRESENTATIVE
Credential:
Phone: 732-769-8877