Provider Demographics
NPI:1336257302
Name:LENAWEE INTERMEDIATE SCHOOL DISTRICT
Entity Type:Organization
Organization Name:LENAWEE INTERMEDIATE SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:S
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-265-1682
Mailing Address - Street 1:2946 SUTTON RD
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-8301
Mailing Address - Country:US
Mailing Address - Phone:517-265-1682
Mailing Address - Fax:517-263-2890
Practice Address - Street 1:2946 SUTTON RD
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-8301
Practice Address - Country:US
Practice Address - Phone:517-265-1682
Practice Address - Fax:517-263-2890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3024759Medicaid