Provider Demographics
NPI:1164500104
Name:DICKINSON-IRON INTERMEDIATE SCHOOL DISTRICT
Entity Type:Organization
Organization Name:DICKINSON-IRON INTERMEDIATE SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL EDUCATION
Authorized Official - Prefix:MR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:RUOHOMAKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:906-779-2692
Mailing Address - Street 1:1074 PYLE DR
Mailing Address - Street 2:
Mailing Address - City:KINGSFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49802-4451
Mailing Address - Country:US
Mailing Address - Phone:906-779-2692
Mailing Address - Fax:906-779-2642
Practice Address - Street 1:1074 PYLE DR
Practice Address - Street 2:
Practice Address - City:KINGSFORD
Practice Address - State:MI
Practice Address - Zip Code:49802-4451
Practice Address - Country:US
Practice Address - Phone:906-779-2692
Practice Address - Fax:906-779-2642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3032779Medicaid