PRAIRIE RESIDENCE CARE, LLC
NPI 1003620055
Assisted Living Facility - Assisted Living, Mental Illness in Eden Prairie, MN
About Prairie Residence Care, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PRAIRIE RESIDENCE CARE, LLC (NPI 1003620055), doing business as Prairie Residenc Care, Llc, is a healthcare organization registered as an assisted living, mental illness in Eden Prairie, Minnesota and active in the NPI registry since February 2025. The organization holds a CLIA Waiver certificate valid through July 9, 2028 and lists Aden Rashid, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 24D2347027
Prairie Residence Care · Eden Prairie, MNOther Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Prairie Residence Care, LLC's NPI number?
The NPI number for Prairie Residence Care, LLC is 1003620055. It was assigned to this organization in the NPPES registry on February 1, 2025. The provider is doing business as Prairie Residenc Care, LLC.
Where is Prairie Residence Care, LLC located?
Prairie Residence Care, LLC is located at 12570 Crowfoot Ct, Eden Prairie, MN 55344. The listed phone number is (612) 461-2158.
What is Prairie Residence Care, LLC's specialty?
The primary specialty registered for this NPI is Assisted Living Facility, specializing in Assisted Living, Mental Illness, with taxonomy code 3104A0625X.
Does Prairie Residence Care, LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 24D2347027) is associated with this NPI, valid through July 9, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Prairie Residence Care, LLC was last updated on February 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Prairie Residence Care, Llc · NPI 1003620055
Assisted Living, Mental Illness organization in Eden Prairie, Minnesota. Organization record, active in the CMS NPPES registry since February 1, 2025.
## Identity
- **NPI:** 1003620055 (Entity type: Organization)
- **Enumerated:** February 1, 2025
- **Primary specialty:** Assisted Living Facility - Assisted Living, Mental Illness · taxonomy 3104A0625X
- **Also known as:** Prairie Residenc Care, LLC (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Aden Rashid, OWNER
## Practice location
- **Address:** 12570 CROWFOOT CT, Eden Prairie, MN 55344-3937
- **Phone:** (612) 461-2158
## Record status
- **NPPES last updated:** February 1, 2025
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1003620055) · Data from the CMS NPPES public registry.