Provider Demographics
NPI:1336220037
Name:IND SCHOOL DIST 47
Entity Type:Organization
Organization Name:IND SCHOOL DIST 47
Other - Org Name:SAUK RAPIDS/RICE PUBLIC SCHOOL DIST ISD 047
Other - Org Type:Other Name
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-253-4703
Mailing Address - Street 1:1833 OSAUKA RD
Mailing Address - Street 2:
Mailing Address - City:SAUK RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:56379-4530
Mailing Address - Country:US
Mailing Address - Phone:320-253-4703
Mailing Address - Fax:320-258-1717
Practice Address - Street 1:1833 OSAUKA RD
Practice Address - Street 2:
Practice Address - City:SAUK RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:56379-4530
Practice Address - Country:US
Practice Address - Phone:320-253-4703
Practice Address - Fax:320-258-1717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN851414300Medicaid