Provider Demographics
NPI:1538840368
Name:WESTERN PRAIRIE HUMAN SERVICES
Entity type:Organization
Organization Name:WESTERN PRAIRIE HUMAN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FISCAL SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-685-8215
Mailing Address - Street 1:211 E MINNESOTA AVE
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:56334-1666
Mailing Address - Country:US
Mailing Address - Phone:320-634-7755
Mailing Address - Fax:
Practice Address - Street 1:211 E MINNESOTA AVE
Practice Address - Street 2:
Practice Address - City:GLENWOOD
Practice Address - State:MN
Practice Address - Zip Code:56334-1666
Practice Address - Country:US
Practice Address - Phone:320-634-7755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare