Provider Demographics
NPI:1245322494
Name:GRATIOT ISABELLA RESD
Entity type:Organization
Organization Name:GRATIOT ISABELLA RESD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MATLOSZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-875-5101
Mailing Address - Street 1:1131 E. CENTER ST., P.O. BOX 310
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:MI
Mailing Address - Zip Code:48847-0310
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:989-875-2858
Practice Address - Street 1:1131 E. CENTER ST.
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:MI
Practice Address - Zip Code:48847-0310
Practice Address - Country:US
Practice Address - Phone:989-875-5101
Practice Address - Fax:989-875-2858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)