Provider Demographics
NPI:1770647604
Name:RIVER BEND EDUCATION DISTRICT
Entity Type:Organization
Organization Name:RIVER BEND EDUCATION DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DOUG
Authorized Official - Middle Name:
Authorized Official - Last Name:HAZEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-359-8700
Mailing Address - Street 1:1315 SOUTH BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NEW ULM
Mailing Address - State:MN
Mailing Address - Zip Code:56073-3474
Mailing Address - Country:US
Mailing Address - Phone:507-359-8700
Mailing Address - Fax:507-359-1161
Practice Address - Street 1:1315 SOUTH BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW ULM
Practice Address - State:MN
Practice Address - Zip Code:56073-3474
Practice Address - Country:US
Practice Address - Phone:507-359-8700
Practice Address - Fax:507-359-1161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN978023800Medicaid