Provider Demographics
NPI:1538227889
Name:HERON LAKE-OKABENA ISD #330
Entity type:Organization
Organization Name:HERON LAKE-OKABENA ISD #330
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:FREKING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-853-4507
Mailing Address - Street 1:124 N MINNESOTA AVENUE
Mailing Address - Street 2:P O BOX 97
Mailing Address - City:OKABENA
Mailing Address - State:NE
Mailing Address - Zip Code:56161-0097
Mailing Address - Country:US
Mailing Address - Phone:507-853-4507
Mailing Address - Fax:507-853-4642
Practice Address - Street 1:124 N MINNESOTA AVENUE
Practice Address - Street 2:
Practice Address - City:OKABENA
Practice Address - State:NE
Practice Address - Zip Code:56161-0097
Practice Address - Country:US
Practice Address - Phone:507-853-4507
Practice Address - Fax:507-853-4642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5392470251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)