Provider Demographics
NPI:1295745156
Name:SWANVILLE SCHOOL DISTRICT
Entity type:Organization
Organization Name:SWANVILLE SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GENE
Authorized Official - Middle Name:D
Authorized Official - Last Name:HARTHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-547-2431
Mailing Address - Street 1:602 DEGRAFF ST
Mailing Address - Street 2:PO BOX 98
Mailing Address - City:SWANVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:56382
Mailing Address - Country:US
Mailing Address - Phone:320-547-2431
Mailing Address - Fax:320-547-2576
Practice Address - Street 1:602 DEGRAFF ST
Practice Address - Street 2:
Practice Address - City:SWANVILLE
Practice Address - State:MN
Practice Address - Zip Code:56382
Practice Address - Country:US
Practice Address - Phone:320-547-2431
Practice Address - Fax:320-547-2576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN759467400Medicaid