Provider Demographics
NPI:1760375117
Name:THE PRAIRIE CENTER, INC
Entity type:Organization
Organization Name:THE PRAIRIE CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:515-802-2832
Mailing Address - Street 1:3307 TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50312-4538
Mailing Address - Country:US
Mailing Address - Phone:515-802-2832
Mailing Address - Fax:
Practice Address - Street 1:3209 INGERSOLL AVE STE 100
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50312-3920
Practice Address - Country:US
Practice Address - Phone:515-344-3566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)