Provider Demographics
NPI:1598017782
Name:ISD #516 ROUND LAKE PS
Entity Type:Organization
Organization Name:ISD #516 ROUND LAKE PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:CORNELIUS
Authorized Official - Middle Name:H
Authorized Official - Last Name:SMIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-945-8123
Mailing Address - Street 1:445 HARRISON STREET
Mailing Address - Street 2:
Mailing Address - City:ROUND LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:56167
Mailing Address - Country:US
Mailing Address - Phone:507-945-8123
Mailing Address - Fax:
Practice Address - Street 1:445 HARRISON STREET
Practice Address - Street 2:
Practice Address - City:ROUND LAKE
Practice Address - State:MN
Practice Address - Zip Code:56167
Practice Address - Country:US
Practice Address - Phone:507-945-8123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)