Healthcare Provider Details

I. General information

NPI: 1528146941
Provider Name (Legal Business Name): INDEPENDENT SCHOOL DISTRICT 150
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 06/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

714 JOSEPH ST
HAWLEY MN
56549
US

IV. Provider business mailing address

PO BOX 209
AUDUBON MN
56511
US

V. Phone/Fax

Practice location:
  • Phone: 218-483-4647
  • Fax:
Mailing address:
  • Phone: 218-439-6876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: NORMA ALTMANN BERGSETH
Title or Position: SPECIAL EDUCATION DIRECTOR
Credential:
Phone: 218-439-6876