Provider Demographics
NPI:1518993781
Name:DELTA-SCHOOLCRAFT INTERMEDIATE SCHOOL DISTRICT
Entity Type:Organization
Organization Name:DELTA-SCHOOLCRAFT INTERMEDIATE SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:KOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:906-786-9300
Mailing Address - Street 1:2525 3RD AVE S
Mailing Address - Street 2:
Mailing Address - City:ESCANABA
Mailing Address - State:MI
Mailing Address - Zip Code:49829-1258
Mailing Address - Country:US
Mailing Address - Phone:906-786-9300
Mailing Address - Fax:906-786-9318
Practice Address - Street 1:2525 3RD AVE S
Practice Address - Street 2:
Practice Address - City:ESCANABA
Practice Address - State:MI
Practice Address - Zip Code:49829-1258
Practice Address - Country:US
Practice Address - Phone:906-786-9300
Practice Address - Fax:906-786-9318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3032723Medicaid