Organization
CASS & MORRISON COS IND SCHOOL DIST 116
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WANDA LANE (THIRD PARTY ADMINISTRATOR)
(218) 454-5532
Entity
Organization
Contact information
Practice address
323 EAST 2ND STREET SOUTH, PILLAGER, MN 56473
(218) 746-3540
Mailing address
804 OAK STREET, BRAINERD, MN 56401
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Enumeration date
10/24/2006
Last updated
11/12/2020
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