Provider Demographics
NPI:1588727143
Name:CENTENNIAL SCHOOL DISTRICT
Entity type:Organization
Organization Name:CENTENNIAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL EDUCATION
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:THACKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-792-5282
Mailing Address - Street 1:4881 101ST LN NE
Mailing Address - Street 2:
Mailing Address - City:CIRCLE PINES
Mailing Address - State:MN
Mailing Address - Zip Code:55014-1554
Mailing Address - Country:US
Mailing Address - Phone:763-792-5282
Mailing Address - Fax:763-792-5250
Practice Address - Street 1:4881 101ST LN NE
Practice Address - Street 2:
Practice Address - City:CIRCLE PINES
Practice Address - State:MN
Practice Address - Zip Code:55014-1554
Practice Address - Country:US
Practice Address - Phone:763-792-5282
Practice Address - Fax:763-792-5250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)