Provider Demographics
NPI:1952462236
Name:THE ISD 622 EDUCATION CENTER
Entity Type:Organization
Organization Name:THE ISD 622 EDUCATION CENTER
Other - Org Name:INDEPENDENT SCHOOL DISTRICT 622
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF SPECIAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:KARON
Authorized Official - Middle Name:
Authorized Official - Last Name:JOYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-748-7450
Mailing Address - Street 1:2520 EAST 12TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:NORTH ST. PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55109-2420
Mailing Address - Country:US
Mailing Address - Phone:651-748-7450
Mailing Address - Fax:651-748-7449
Practice Address - Street 1:2520 EAST 12TH AVENUE
Practice Address - Street 2:
Practice Address - City:NORTH ST. PAUL
Practice Address - State:MN
Practice Address - Zip Code:55109-2420
Practice Address - Country:US
Practice Address - Phone:651-748-7450
Practice Address - Fax:651-748-7449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN952822900Medicaid