Provider Demographics
NPI:1790213387
Name:STAR OF THE NORTH ACADEMY
Entity Type:Organization
Organization Name:STAR OF THE NORTH ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LULI
Authorized Official - Middle Name:
Authorized Official - Last Name:AXHIJAJ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-450-5561
Mailing Address - Street 1:1562 VIKING BLVD NE
Mailing Address - Street 2:
Mailing Address - City:EAST BETHEL
Mailing Address - State:MN
Mailing Address - Zip Code:55011-9402
Mailing Address - Country:US
Mailing Address - Phone:763-450-5561
Mailing Address - Fax:
Practice Address - Street 1:1562 VIKING BLVD NE
Practice Address - Street 2:
Practice Address - City:EAST BETHEL
Practice Address - State:MN
Practice Address - Zip Code:55011-9402
Practice Address - Country:US
Practice Address - Phone:763-450-5561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)