Provider Demographics
NPI:1649597212
Name:IMAGINE MADISON AVENUE SCHOOL OF ARTS
Entity type:Organization
Organization Name:IMAGINE MADISON AVENUE SCHOOL OF ARTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LOUANN
Authorized Official - Middle Name:
Authorized Official - Last Name:FLICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-259-4000
Mailing Address - Street 1:1511 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-4433
Mailing Address - Country:US
Mailing Address - Phone:419-259-4000
Mailing Address - Fax:419-243-1513
Practice Address - Street 1:1511 MADISON AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-4433
Practice Address - Country:US
Practice Address - Phone:419-259-4000
Practice Address - Fax:419-243-1513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-22
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)