Organization
ISD 2164
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY BRUER (SUPERINTENDENT)
(218) 287-2371
Entity
Organization
Contact information
Practice address
108 MAIN STREET NORTH, DILWORTH, MN 56529
(218) 287-2371
Mailing address
PO BOX 188, DILWORTH, MN 56529
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
1649373
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
460070300
MHCP PROVIDER NUMBER
MN
Enumeration date
12/11/2006
Last updated
08/11/2008
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