Provider Demographics
NPI:1346554235
Name:LIONSGATE ACADEMY
Entity Type:Organization
Organization Name:LIONSGATE ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNDY-EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-486-5359
Mailing Address - Street 1:3420 NEVADA AVE N
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL
Mailing Address - State:MN
Mailing Address - Zip Code:55427-2187
Mailing Address - Country:US
Mailing Address - Phone:763-486-5359
Mailing Address - Fax:763-390-0012
Practice Address - Street 1:3420 NEVADA AVE N
Practice Address - Street 2:
Practice Address - City:CRYSTAL
Practice Address - State:MN
Practice Address - Zip Code:55427-2187
Practice Address - Country:US
Practice Address - Phone:763-486-5359
Practice Address - Fax:763-390-0012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-03
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)