=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831254028
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LONG PRAIRIE GREY EAGLE PUBLIC SCHOOLS DISTRICT 2753
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/27/2006
-----------------------------------------------------
Last Update Date | 06/18/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 205 2ND ST S
-----------------------------------------------------
City | LONG PRAIRIE
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 56347-1353
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 320-732-2194
-----------------------------------------------------
Fax | 320-732-3791
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 205 2ND ST S
-----------------------------------------------------
City | LONG PRAIRIE
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 56347-1353
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 320-732-2194
-----------------------------------------------------
Fax | 320-732-3791
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SUPERINTENDENT
-----------------------------------------------------
Name | DONALD HANSEN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 320-732-2194
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251300000X
-----------------------------------------------------
Taxonomy Name | Local Education Agency (LEA)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------