Provider Demographics
NPI:1710232434
Name:PRAIRIE HILLS MEALS PROGRAM
Entity Type:Organization
Organization Name:PRAIRIE HILLS MEALS PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:K
Authorized Official - Last Name:CLINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-642-6613
Mailing Address - Street 1:2015 TUMBLEWEED TRL
Mailing Address - Street 2:
Mailing Address - City:SPEARFISH
Mailing Address - State:SD
Mailing Address - Zip Code:57783-8810
Mailing Address - Country:US
Mailing Address - Phone:605-642-6613
Mailing Address - Fax:
Practice Address - Street 1:2340 EAST AVE
Practice Address - Street 2:
Practice Address - City:STURGIS
Practice Address - State:SD
Practice Address - Zip Code:57785-3307
Practice Address - Country:US
Practice Address - Phone:605-642-6613
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals