Provider Demographics
NPI:1821852690
Name:MARINE VILLAGE SCHOOL
Entity Type:Organization
Organization Name:MARINE VILLAGE SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:KOKX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-477-0380
Mailing Address - Street 1:550 PINE ST
Mailing Address - Street 2:
Mailing Address - City:MARINE ON SAINT CROIX
Mailing Address - State:MN
Mailing Address - Zip Code:55047-4417
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:550 PINE ST
Practice Address - Street 2:
Practice Address - City:MARINE ON SAINT CROIX
Practice Address - State:MN
Practice Address - Zip Code:55047-4417
Practice Address - Country:US
Practice Address - Phone:651-477-0380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)