Provider Demographics
NPI:1487109609
Name:LEVEL UP ACADEMY
Entity type:Organization
Organization Name:LEVEL UP ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNERSHIP DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:DANDELET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-408-5559
Mailing Address - Street 1:2600 COUNTY ROAD E E
Mailing Address - Street 2:
Mailing Address - City:WHITE BEAR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55110-4964
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2600 COUNTY ROAD E E
Practice Address - Street 2:
Practice Address - City:WHITE BEAR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55110-4964
Practice Address - Country:US
Practice Address - Phone:651-408-5559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-17
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)