| Prairie Lakes Youth Programs | |
|
1808 Civic Center Dr Willmar MN 56201-9446 | |
| (320) 231-1729 | |
| (321) 231-1166 |
| Full Name | Prairie Lakes Youth Programs |
|---|---|
| Speciality | Counselor |
| Location | 1808 Civic Center Dr, Willmar, Minnesota |
| Authorized Official Name and Position | Darin Balken (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3202311729 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prairie Lakes Youth Programs 1808 Civic Center Dr Po Box 894 Willmar MN 56201-9446 Ph: (320) 231-1729 | Prairie Lakes Youth Programs 1808 Civic Center Dr Willmar MN 56201-9446 Ph: (320) 231-1729 |
| NPI Number | 1699958777 |
|---|---|
| Provider Enumeration Date | 12/11/2007 |
| Last Update Date | 12/11/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699958777 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 1036941-1-CRF (Minnesota) | Primary |
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