Provider Demographics
NPI:1285911750
Name:MINNETONKA PUBLIC SCHOOLS
Entity type:Organization
Organization Name:MINNETONKA PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR OF STUDENT SUPPO
Authorized Official - Prefix:DR
Authorized Official - First Name:JAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:BOOTSMA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:952-401-5017
Mailing Address - Street 1:5621 COUNTY ROAD 101
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-4214
Mailing Address - Country:US
Mailing Address - Phone:952-401-5017
Mailing Address - Fax:952-401-5032
Practice Address - Street 1:5621 COUNTY ROAD 101
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-4214
Practice Address - Country:US
Practice Address - Phone:952-401-5017
Practice Address - Fax:952-401-5032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-10
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)