Provider Demographics
NPI:1013001932
Name:LONETREE SPECIAL EDUCATION UNIT
Entity Type:Organization
Organization Name:LONETREE SPECIAL EDUCATION UNIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:ODDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-324-4811
Mailing Address - Street 1:210 NORTH STREET EAST
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:ND
Mailing Address - Zip Code:58341-1027
Mailing Address - Country:US
Mailing Address - Phone:701-324-4811
Mailing Address - Fax:701-324-4812
Practice Address - Street 1:210 NORTH STREET EAST
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:ND
Practice Address - Zip Code:58341-1027
Practice Address - Country:US
Practice Address - Phone:701-324-4811
Practice Address - Fax:701-324-4812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND019015Medicaid