Provider Demographics
NPI:1922147875
Name:BURLEIGH COUNTY SPECIAL EDUCATION UNIT
Entity Type:Organization
Organization Name:BURLEIGH COUNTY SPECIAL EDUCATION UNIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:RYBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-258-6299
Mailing Address - Street 1:4007 STATE ST STE 101
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-0689
Mailing Address - Country:US
Mailing Address - Phone:701-258-6299
Mailing Address - Fax:701-258-5195
Practice Address - Street 1:4007 STATE ST STE 101
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-0689
Practice Address - Country:US
Practice Address - Phone:701-258-6299
Practice Address - Fax:701-258-5195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND19010Medicaid