Provider Demographics
NPI:1225270077
Name:TRIO WOLF CREEK DISTANCE LEARNING CHARTER SCHOOL
Entity Type:Organization
Organization Name:TRIO WOLF CREEK DISTANCE LEARNING CHARTER SCHOOL
Other - Org Name:WOLF CREEK ONLINE HIGH SCHOOL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:QUARNSTROM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-213-2017
Mailing Address - Street 1:13750 LAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:LINDSTROM
Mailing Address - State:MN
Mailing Address - Zip Code:55045-9361
Mailing Address - Country:US
Mailing Address - Phone:651-213-2017
Mailing Address - Fax:651-257-0576
Practice Address - Street 1:10363 LIBERTY LANE
Practice Address - Street 2:
Practice Address - City:CHISAGO CITY
Practice Address - State:MN
Practice Address - Zip Code:55013
Practice Address - Country:US
Practice Address - Phone:651-213-2017
Practice Address - Fax:651-257-0576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-25
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)