Provider Demographics
NPI:1215220181
Name:IND SCHOOL DIST 424
Entity Type:Organization
Organization Name:IND SCHOOL DIST 424
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-395-2521
Mailing Address - Street 1:131 HICKORY ST N
Mailing Address - Street 2:
Mailing Address - City:LESTER PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55354-7743
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:131 HICKORY ST N
Practice Address - Street 2:
Practice Address - City:LESTER PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55354-7743
Practice Address - Country:US
Practice Address - Phone:320-395-2521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-25
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN574160200Medicaid