Provider Demographics
NPI:1144265620
Name:ALLEGAN COUNTY INTERMEDIATE SCHOOL DISTRICT
Entity type:Organization
Organization Name:ALLEGAN COUNTY INTERMEDIATE SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:L
Authorized Official - Last Name:FULLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-673-2161
Mailing Address - Street 1:310 THOMAS ST
Mailing Address - Street 2:
Mailing Address - City:ALLEGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49010-9158
Mailing Address - Country:US
Mailing Address - Phone:269-673-2161
Mailing Address - Fax:269-673-2361
Practice Address - Street 1:310 THOMAS ST
Practice Address - Street 2:
Practice Address - City:ALLEGAN
Practice Address - State:MI
Practice Address - Zip Code:49010-9158
Practice Address - Country:US
Practice Address - Phone:269-673-2161
Practice Address - Fax:269-673-2361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)