Provider Demographics
NPI:1467524389
Name:TRAVERSE COUNTY IND SCHOOL DIST 801
Entity Type:Organization
Organization Name:TRAVERSE COUNTY IND SCHOOL DIST 801
Other - Org Name:BROWNS VALLEY PUBLIC SCHOOLS ISD 801
Other - Org Type:Other Name
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-695-2103
Mailing Address - Street 1:118 CHURCH STREET
Mailing Address - Street 2:
Mailing Address - City:BROWNS VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:56219
Mailing Address - Country:US
Mailing Address - Phone:320-695-2103
Mailing Address - Fax:320-695-2868
Practice Address - Street 1:118 CHURCH STREET
Practice Address - Street 2:
Practice Address - City:BROWNS VALLEY
Practice Address - State:MN
Practice Address - Zip Code:56219
Practice Address - Country:US
Practice Address - Phone:320-695-2103
Practice Address - Fax:320-695-2868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN589152300Medicaid