Provider Demographics
NPI:1316584139
Name:ST. PAUL SCHOOL OF NORTHERN LIGHTS
Entity Type:Organization
Organization Name:ST. PAUL SCHOOL OF NORTHERN LIGHTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM SCHOOL LEADER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NGENDAKURIYO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-285-4672
Mailing Address - Street 1:426 OSCEOLA AVE S
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-3535
Mailing Address - Country:US
Mailing Address - Phone:651-285-4672
Mailing Address - Fax:
Practice Address - Street 1:426 OSCEOLA AVE S
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-3535
Practice Address - Country:US
Practice Address - Phone:651-285-4672
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-01
Last Update Date:2019-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)