Provider Demographics
NPI:1588794317
Name:PRAIRIE CENTER HEALTH SYSTEMS, INC
Entity type:Organization
Organization Name:PRAIRIE CENTER HEALTH SYSTEMS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:RANEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-693-3081
Mailing Address - Street 1:718 W KILLARNEY ST
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61801-1015
Mailing Address - Country:US
Mailing Address - Phone:217-328-4500
Mailing Address - Fax:217-239-1129
Practice Address - Street 1:718 W KILLARNEY ST
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:IL
Practice Address - Zip Code:61801-1015
Practice Address - Country:US
Practice Address - Phone:217-328-4500
Practice Address - Fax:217-239-1129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILA-0606-0004-A101YA0400X, 261QR0405X
ILA-0606-0007-A101YA0400X, 261QR0405X
ILA-0606-0001-A261QR0405X, 101YA0400X
ILA-0606-0002-A324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use DisorderGroup - Single Specialty
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility