Provider Demographics
NPI:1326385915
Name:STARRY NIGHT ART AND NATURE CONSERVATORY
Entity Type:Organization
Organization Name:STARRY NIGHT ART AND NATURE CONSERVATORY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:LANNEN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:989-772-2833
Mailing Address - Street 1:1023 PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LAKE ISABELLA
Mailing Address - State:MI
Mailing Address - Zip Code:48893-9349
Mailing Address - Country:US
Mailing Address - Phone:989-621-6841
Mailing Address - Fax:989-772-2833
Practice Address - Street 1:1023 PARKVIEW DR
Practice Address - Street 2:
Practice Address - City:LAKE ISABELLA
Practice Address - State:MI
Practice Address - Zip Code:48893-9349
Practice Address - Country:US
Practice Address - Phone:989-621-6841
Practice Address - Fax:989-772-2833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-15
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable