MEDICARE: RICE DAKOTA & GOODHUE COS IND SCHOOL DISTRICT 659

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1265563522
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICE DAKOTA & GOODHUE COS IND SCHOOL DISTRICT 659

Provider Business Mailing Address
First Line	:	201 ORCHARD ST
Second Line	:
City	:	NORTHFIELD
State	:	MN
Zip	:	55057-1663
Country	:	US
Telephone Number	:	507-645-1200
Fax Number	:	507-645-1250

Provider Business Practice Location Address
First Line	:	201 ORCHARD ST
Second Line	:
City	:	NORTHFIELD
State	:	MN
Zip	:	55057-1663
Country	:	US
Telephone Number	:	507-645-1200
Fax Number	:	507-645-1250

Authorized Official
Title or Position	:	DIRECTOR OF STUDENT SERVICES
Name	:	GARY LEWIS
Credential	:
Telephone Number	:	507-645-3441

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	08/28/2008

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