Provider Demographics
NPI:1063121101
Name:CREEKSTONE MONTESSORI SCHOOL
Entity type:Organization
Organization Name:CREEKSTONE MONTESSORI SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MANDELKOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-327-2218
Mailing Address - Street 1:5225 HIGHWAY 61 W STE 3
Mailing Address - Street 2:
Mailing Address - City:RED WING
Mailing Address - State:MN
Mailing Address - Zip Code:55066-1117
Mailing Address - Country:US
Mailing Address - Phone:651-327-2468
Mailing Address - Fax:
Practice Address - Street 1:5225 HIGHWAY 61 W STE 3
Practice Address - Street 2:
Practice Address - City:RED WING
Practice Address - State:MN
Practice Address - Zip Code:55066-1117
Practice Address - Country:US
Practice Address - Phone:651-327-2468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)