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General NPI Number Information
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NPI Number | 1003177619
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Entity Type | Organization
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Legal Business Name | AFSA HIGH SCHOOL
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Dates
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Enumeration Date | 05/31/2012
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Last Update Date | 05/31/2012
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Provider Practice Location Address
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Address Line | 100 VADNAIS BLVD
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City | VADNAIS HEIGHTS
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State | MN
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Zip | 55127-4036
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Country | US
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Telephone | 651-209-3910
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Fax | 651-209-3911
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Provider Business Mailing Address
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Address Line | 100 VADNAIS BLVD
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City | VADNAIS HEIGHTS
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State | MN
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Zip | 55127-4036
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Country | US
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Telephone | 651-209-3910
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Fax | 651-209-3911
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | BECKY MEYER
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Credential |
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Telephone | 651-209-3910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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