Provider Demographics
NPI:1245637552
Name:RANDOLPH SCHOOL DISTRICT 195
Entity type:Organization
Organization Name:RANDOLPH SCHOOL DISTRICT 195
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-645-7409
Mailing Address - Street 1:29110 DAVISSON AVE
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MN
Mailing Address - Zip Code:55065-7803
Mailing Address - Country:US
Mailing Address - Phone:507-645-7409
Mailing Address - Fax:507-645-5950
Practice Address - Street 1:29110 DAVISSON AVE
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MN
Practice Address - Zip Code:55065-7803
Practice Address - Country:US
Practice Address - Phone:507-645-7409
Practice Address - Fax:507-645-5950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-02
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)