Provider Demographics
NPI:1710994900
Name:SANILAC INTERMEDIATE SCHOOL DISTRICT
Entity Type:Organization
Organization Name:SANILAC INTERMEDIATE SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:DENTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-648-4700
Mailing Address - Street 1:46 N JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:MI
Mailing Address - Zip Code:48471-1132
Mailing Address - Country:US
Mailing Address - Phone:810-648-2200
Mailing Address - Fax:810-648-2275
Practice Address - Street 1:46 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:MI
Practice Address - Zip Code:48471-1132
Practice Address - Country:US
Practice Address - Phone:810-648-2200
Practice Address - Fax:810-648-2275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2983351Medicaid