Provider Demographics
NPI:1225195191
Name:NORTH SHORE COMMUNITY SCHOOL #4084
Entity Type:Organization
Organization Name:NORTH SHORE COMMUNITY SCHOOL #4084
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-525-0663
Mailing Address - Street 1:5926 RYAN RD
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55804-9672
Mailing Address - Country:US
Mailing Address - Phone:218-525-0663
Mailing Address - Fax:218-525-0024
Practice Address - Street 1:5926 RYAN RD
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55804-9672
Practice Address - Country:US
Practice Address - Phone:218-525-0663
Practice Address - Fax:218-525-0024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)