Provider Demographics
NPI:1245513522
Name:OSHKI OGIMAAG CHARTER SCHOOL
Entity type:Organization
Organization Name:OSHKI OGIMAAG CHARTER SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FRED
Authorized Official - Middle Name:
Authorized Official - Last Name:KASIANOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-475-2112
Mailing Address - Street 1:73 UPPER RD
Mailing Address - Street 2:
Mailing Address - City:GRAND PORTAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55605-3010
Mailing Address - Country:US
Mailing Address - Phone:218-475-2112
Mailing Address - Fax:
Practice Address - Street 1:73 UPPER RD
Practice Address - Street 2:
Practice Address - City:GRAND PORTAGE
Practice Address - State:MN
Practice Address - Zip Code:55605-3010
Practice Address - Country:US
Practice Address - Phone:218-475-2112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty