Provider Demographics
NPI:1821293101
Name:THE PRAIRIE CENTRE FOR THE FAMILY LLC
Entity Type:Organization
Organization Name:THE PRAIRIE CENTRE FOR THE FAMILY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CLAYTON
Authorized Official - Middle Name:RONALD
Authorized Official - Last Name:HOUFF
Authorized Official - Suffix:SR
Authorized Official - Credentials:LAMFT, LADC
Authorized Official - Phone:507-532-2715
Mailing Address - Street 1:800 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MN
Mailing Address - Zip Code:56258-2573
Mailing Address - Country:US
Mailing Address - Phone:507-532-2715
Mailing Address - Fax:507-532-2678
Practice Address - Street 1:800 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MN
Practice Address - Zip Code:56258-2573
Practice Address - Country:US
Practice Address - Phone:507-532-2715
Practice Address - Fax:507-532-2678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1046409-1-CDT261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder