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NPI Code Detail

MEDICARE: THE ISD 622 EDUCATION CENTER

MEDICARE: THE ISD 622 EDUCATION CENTER
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
1251300000XLocal Education Agency (LEA)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952462236
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE ISD 622 EDUCATION CENTER
Provider Business Mailing Address
First Line : 2520 EAST 12TH AVENUE
Second Line :
City : NORTH ST. PAUL
State : MN
Zip : 55109-2420
Country : US
Telephone Number : 651-748-7450
Fax Number : 651-748-7449
Provider Business Practice Location Address
First Line : 2520 EAST 12TH AVENUE
Second Line :
City : NORTH ST. PAUL
State : MN
Zip : 55109-2420
Country : US
Telephone Number : 651-748-7450
Fax Number : 651-748-7449
Authorized Official
Title or Position : DIRECTOR OF SPECIAL SERVICES
Name : KARON JOYER
Credential :
Telephone Number : 651-748-7450
Provider Enumeration Date : 12/12/2006
Last Update Date : 07/15/2008

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Directions to “THE ISD 622 EDUCATION CENTER ” Practice Location

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