Organization
CASS & CROW WINGS COS IND SCHOOL DIST 2174
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WANDA LANE (THIRD PARTY ADMINISTRATOR)
(218) 454-5532
Entity
Organization
Contact information
Practice address
401 MURRAY AVENUE, PINE RIVER, MN 56474
(218) 587-8000
(218) 587-4721
Mailing address
804 OAK ST., BRAINERD, MN 56401
(218) 454-5532
(218) 828-2148
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Enumeration date
10/16/2006
Last updated
10/27/2020
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