Provider Demographics
NPI:1871655175
Name:IND SCHOOL DIST 391
Entity Type:Organization
Organization Name:IND SCHOOL DIST 391
Other - Org Name:CLEVELAND PUBLIC SCHOOL
Other - Org Type:Other Name
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-931-5953
Mailing Address - Street 1:400 6TH ST
Mailing Address - Street 2:BOX 310
Mailing Address - City:CLEVELAND
Mailing Address - State:MN
Mailing Address - Zip Code:56017
Mailing Address - Country:US
Mailing Address - Phone:507-931-5953
Mailing Address - Fax:507-931-9088
Practice Address - Street 1:400 6TH ST
Practice Address - Street 2:BOX 310
Practice Address - City:CLEVELAND
Practice Address - State:MN
Practice Address - Zip Code:56017
Practice Address - Country:US
Practice Address - Phone:507-931-5953
Practice Address - Fax:507-931-9088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN502405600OtherMN HEALTH CARE PROGRAM