PRAIRIECARE
NPI 1629353495
Psychiatric Hospital in Maple Grove, MN

Active since October 12, 2011CLIA Certified · 4 labs
12915 63RD AVE N, MAPLE GROVE, MN 55369(952) 826-8405 Get Directions Write a Review

NPPES record last updated: October 12, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Prairiecare NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRAIRIECARE (NPI 1629353495) is a healthcare organization registered as a psychiatric hospital in Maple Grove, Minnesota and active in the NPI registry since October 2011. The organization holds 4 active CLIA laboratory certificates and lists Joel Oberstar, Ceo, as its authorized official.

NPPES Registry Identity

NPI1629353495
Entity TypeOrganization
Primary Taxonomy283Q00000X
Legal Business NamePRAIRIECARE
Location Address12915 63RD AVE NMaple Grove, MN 55369-6001
Mailing Address12915 63rd Ave NMaple Grove, MN 55369-6001 · (952) 826-8405
Organization SubpartNo
Authorized OfficialJoel OberstarCeo · (763) 383-5800
Enumeration DateOctober 12, 2011
NPI 1629353495 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychiatric HospitalHospitals
Taxonomy Code283Q00000X
License Licensed in MN · 26-3715906
Definition

An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings.

12915 63RD AVE N, Maple Grove, MN 55369

CLIA Laboratory Certificates CMS CLIA 4

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 24D2017916

Prairiecare Residential Services · Maple Grove, MN
Active · expires Dec 20, 2026
CLIA Number24D2017916
Laboratory TypeBehavioral Health
Certificate Effective DateDecember 21, 2024
Certificate Expiration DateDecember 20, 2026
Laboratory DirectorDr. Ryan Williams
Laboratory Phone(952) 826-8435
Laboratory LocationPrairiecare Residential Services12915 63rd Ave N, Maple Grove, MN 55369
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 24D2076280

Prairiecare Medical Group · Rochester, MN
Active · expires Apr 14, 2028
CLIA Number24D2076280
Laboratory TypePsychiatric Outpatient Pr
Certificate Effective DateApril 15, 2026
Certificate Expiration DateApril 14, 2028
Laboratory DirectorDr. Ryan Williams
Laboratory Phone(763) 383-5800
Laboratory LocationPrairiecare Medical Group5255 Members Pkwy NW, Rochester, MN 55901
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 24D2108896

Prairiecare LLC · Maplewood, MN
Active · expires Feb 15, 2028
CLIA Number24D2108896
Laboratory TypeMental Health Clinic
Certificate Effective DateFebruary 16, 2026
Certificate Expiration DateFebruary 15, 2028
Laboratory DirectorDr. Ryan Williams
Laboratory Phone(763) 383-5800
Laboratory LocationPrairiecare LLC2001 Beam Ave, Maplewood, MN 55109
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 24D2098950

Prairiecare LLC · Brooklyn Park, MN
Active · expires Jul 16, 2027
CLIA Number24D2098950
Laboratory TypePsychiatric Hospital
Certificate Effective DateJuly 17, 2025
Certificate Expiration DateJuly 16, 2027
Laboratory DirectorDr. Ryan Willims
Laboratory Phone(763) 383-5800
Laboratory LocationPrairiecare LLC9400 Zane Ave N, Brooklyn Park, MN 55443
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Social Worker (Clinical)
12915 63RD AVE N
MAPLE GROVE, MN 55369
Social Worker (Clinical)
12915 63RD AVE N
MAPLE GROVE, MN 55369
Social Worker (Clinical)
12915 63RD AVE N
MAPLE GROVE, MN 55369
Social Worker (Clinical)
12915 63RD AVE N
MAPLE GROVE, MN 55369
Recreation Therapist
12915 63RD AVE N
MAPLE GROVE, MN 55369
Behavior Analyst
12915 63RD AVE N
MAPLE GROVE, MN 55369
Psychiatric Residential Treatment Facility
12915 63RD AVE N
MAPLE GROVE, MN 55369
Psychiatric Hospital
12915 63RD AVE N
MAPLE GROVE, MN 55369

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 Prairiecare's NPI number?

The NPI number for Prairiecare is 1629353495. It was assigned to this organization in the NPPES registry on October 12, 2011.

Where is Prairiecare located?

Prairiecare is located at 12915 63rd Ave N, Maple Grove, MN 55369. The listed phone number is (952) 826-8405.

What is Prairiecare's specialty?

The primary specialty registered for this NPI is Psychiatric Hospital with taxonomy code 283Q00000X.

Does Prairiecare hold CLIA laboratory certificates?

Yes. 4 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Prairiecare was last updated on October 12, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.