OrganizationActive
Prairie St. John'S, LLC
NPI 1366681918 · Substance Abuse Rehabilitation Facility · Fargo, ND
Provider details
- NPI number
- 1366681918
- Entity type
- Organization
- Primary specialty
- Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Thomas Eide, Cfo(701) 476-7200
- License
- 597-1-1-08A (ND)
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
Detailed profile(86/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
510 4th St. South
Fargo, ND 58103
Phone: (401) 478-7517
Fax: (701) 478-7524
Street-level locationGet directions
Mailing address
510 4th St. South
Fargo, ND 58103
Registry dates
- Enumerated
- 2009-02-05
- Last updated
- 2009-02-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.