Provider Demographics
NPI:1922183003
Name:MONTROSE SCHOOL 43-2
Entity Type:Organization
Organization Name:MONTROSE SCHOOL 43-2
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VI
Authorized Official - Middle Name:
Authorized Official - Last Name:ENGBRECHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-271-0218
Mailing Address - Street 1:715 E 14TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-5151
Mailing Address - Country:US
Mailing Address - Phone:605-271-0218
Mailing Address - Fax:605-271-0220
Practice Address - Street 1:715 E 14TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-5151
Practice Address - Country:US
Practice Address - Phone:605-271-0218
Practice Address - Fax:605-271-0220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5152370Medicaid