Organization
ST. JOSEPH COUNTY ISD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLLEEN CONKLE (FINANCIAL ASSISTANT)
(269) 467-5418
Entity
Organization
Contact information
Practice address
62445 SHIMMEL RD, CENTREVILLE, MI 49032-9527
(269) 467-5400
(269) 467-4309
Mailing address
62445 SHIMMEL RD, CENTREVILLE, MI 49032-9527
(269) 467-5400
(269) 467-4309
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2989210
—
MI
Enumeration date
11/09/2006
Last updated
08/22/2020
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