Provider Demographics
NPI:1730273939
Name:ISD 721 NEW PRAGUE AREA SCHOOLS
Entity type:Organization
Organization Name:ISD 721 NEW PRAGUE AREA SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:G
Authorized Official - Last Name:KERMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-758-1767
Mailing Address - Street 1:405 1ST AVE NW
Mailing Address - Street 2:
Mailing Address - City:NEW PRAGUE
Mailing Address - State:MN
Mailing Address - Zip Code:56071-1436
Mailing Address - Country:US
Mailing Address - Phone:952-758-1688
Mailing Address - Fax:
Practice Address - Street 1:405 1ST AVE NW
Practice Address - Street 2:
Practice Address - City:NEW PRAGUE
Practice Address - State:MN
Practice Address - Zip Code:56071-1436
Practice Address - Country:US
Practice Address - Phone:952-758-1688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN846614900Medicaid