Provider Demographics
NPI:1790867679
Name:IND SCHOOL DIST 306
Entity Type:Organization
Organization Name:IND SCHOOL DIST 306
Other - Org Name:LAPORTE ISD #306
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HARVEY
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-224-2288
Mailing Address - Street 1:315 MAIN ST W
Mailing Address - Street 2:
Mailing Address - City:LAPORTE
Mailing Address - State:MN
Mailing Address - Zip Code:56461-4659
Mailing Address - Country:US
Mailing Address - Phone:218-224-2288
Mailing Address - Fax:218-224-2905
Practice Address - Street 1:315 MAIN ST W
Practice Address - Street 2:
Practice Address - City:LAPORTE
Practice Address - State:MN
Practice Address - Zip Code:56461-4659
Practice Address - Country:US
Practice Address - Phone:218-224-2288
Practice Address - Fax:218-224-2905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN090915700Medicaid