Provider Demographics
NPI:1043399694
Name:KASSON-MANTORVILLE #204
Entity Type:Organization
Organization Name:KASSON-MANTORVILLE #204
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-634-1100
Mailing Address - Street 1:101 16TH ST NE
Mailing Address - Street 2:
Mailing Address - City:KASSON
Mailing Address - State:MN
Mailing Address - Zip Code:55944-1610
Mailing Address - Country:US
Mailing Address - Phone:507-634-1100
Mailing Address - Fax:507-634-6661
Practice Address - Street 1:101 16TH ST NE
Practice Address - Street 2:
Practice Address - City:KASSON
Practice Address - State:MN
Practice Address - Zip Code:55944-1610
Practice Address - Country:US
Practice Address - Phone:507-634-1100
Practice Address - Fax:507-634-6661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)