Provider Demographics
NPI:1497888739
Name:SCHOOL CITY OF MISHAWAKA
Entity Type:Organization
Organization Name:SCHOOL CITY OF MISHAWAKA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR JOINT SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAM
Authorized Official - Middle Name:
Authorized Official - Last Name:VON RAHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-254-4528
Mailing Address - Street 1:1402 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46544-5241
Mailing Address - Country:US
Mailing Address - Phone:574-254-4500
Mailing Address - Fax:574-254-4582
Practice Address - Street 1:1402 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46544-5241
Practice Address - Country:US
Practice Address - Phone:574-254-4500
Practice Address - Fax:574-254-4582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)