Provider Demographics
NPI:1336205673
Name:IND SCHOOL DIST 277
Entity Type:Organization
Organization Name:IND SCHOOL DIST 277
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:BORG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-491-8001
Mailing Address - Street 1:5901 SUNNYFIELD ROAD EAST
Mailing Address - Street 2:
Mailing Address - City:MINNETRISTA
Mailing Address - State:MN
Mailing Address - Zip Code:55364
Mailing Address - Country:US
Mailing Address - Phone:952-491-8005
Mailing Address - Fax:952-491-8012
Practice Address - Street 1:5700 GAME FARM RD E
Practice Address - Street 2:
Practice Address - City:MINNETRISTA
Practice Address - State:MN
Practice Address - Zip Code:55364-8401
Practice Address - Country:US
Practice Address - Phone:952-491-8031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN732673400Medicaid