Provider Demographics
NPI:1265505523
Name:INDEPENDENT SCHOOL DISTRICT #0775
Entity Type:Organization
Organization Name:INDEPENDENT SCHOOL DISTRICT #0775
Other - Org Name:KERKHOVEN-MURDOCK-SUNBURG
Other - Org Type:Other Name
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HEIDELBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-264-1411
Mailing Address - Street 1:302 15TH ST N
Mailing Address - Street 2:
Mailing Address - City:KERKHOVEN
Mailing Address - State:MN
Mailing Address - Zip Code:56252-0000
Mailing Address - Country:US
Mailing Address - Phone:320-264-1411
Mailing Address - Fax:
Practice Address - Street 1:302 15TH ST N
Practice Address - Street 2:
Practice Address - City:KERKHOVEN
Practice Address - State:MN
Practice Address - Zip Code:56252-0000
Practice Address - Country:US
Practice Address - Phone:320-264-1411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)