Provider Demographics
NPI:1164678975
Name:RUM RIVER SPECIAL EDUCATION COOPERATIVE
Entity Type:Organization
Organization Name:RUM RIVER SPECIAL EDUCATION COOPERATIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL EDUCATION
Authorized Official - Prefix:MS
Authorized Official - First Name:PAULINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BANGMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-689-3600
Mailing Address - Street 1:140 BUCHANAN ST N STE 150
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MN
Mailing Address - Zip Code:55008-1640
Mailing Address - Country:US
Mailing Address - Phone:763-689-3600
Mailing Address - Fax:763-689-3601
Practice Address - Street 1:140 BUCHANAN ST N STE 150
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MN
Practice Address - Zip Code:55008-1640
Practice Address - Country:US
Practice Address - Phone:763-689-3600
Practice Address - Fax:763-689-3601
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IND SCHOOL DISTRICT 911
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN640050700Medicaid