Provider Demographics
NPI:1700957305
Name:MIDWEST SPECIAL EDUCATION COOPERATIVE #5-398
Entity Type:Organization
Organization Name:MIDWEST SPECIAL EDUCATION COOPERATIVE #5-398
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL EDUCATION
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-589-4248
Mailing Address - Street 1:203 S COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:MN
Mailing Address - Zip Code:56267-1543
Mailing Address - Country:US
Mailing Address - Phone:320-589-4248
Mailing Address - Fax:320-589-0435
Practice Address - Street 1:203 S COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:MORRIS
Practice Address - State:MN
Practice Address - Zip Code:56267-1543
Practice Address - Country:US
Practice Address - Phone:320-589-4248
Practice Address - Fax:320-589-0435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)