OrganizationActive
Prairie Harbor, LLC
NPI 1235565797 · Emotionally Disturbed Childrens' Residential Treatment Facility · Wallis, TX
Provider details
- NPI number
- 1235565797
- Entity type
- Organization
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities
- Authorized official
- Randall Bryant, Executive Director
Mailing address
Po Box 517
Wallis, TX 77485-0517
Registry dates
- Enumerated
- 2013-09-16
- Last updated
- 2014-02-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.