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General NPI Number Information
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NPI Number | 1538840368
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Entity Type | Organization
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Legal Business Name | WESTERN PRAIRIE HUMAN SERVICES
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Dates
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Enumeration Date | 07/25/2023
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Last Update Date | 07/25/2023
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Provider Practice Location Address
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Address Line | 211 E MINNESOTA AVE
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City | GLENWOOD
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State | MN
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Zip | 56334-1666
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Country | US
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Telephone | 320-634-7755
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Fax |
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Provider Business Mailing Address
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Address Line | 211 E MINNESOTA AVE
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City | GLENWOOD
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State | MN
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Zip | 56334-1666
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Country | US
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Telephone | 320-634-7755
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Fax |
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Authorized Official
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Title or Position | FISCAL SUPERVISOR
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Name | TRACY BOWMAN
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Credential |
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Telephone | 218-685-8215
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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