Woodbury Leadership Academy 4228-07

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

WOODBURY LEADERSHIP ACADEMY 4228-07

Practice address

600 Weir Dr
Woodbury, MN 55125-1240

Phone

(612) 325-2268

NPI assigned

Mar 11, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mary F. Kelly

Title

Director of Special Education

Phone

(612) 325-2268

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1457654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479340800000",
    "number": "1245691773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 WEIR DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251240",
            "telephone_number": "612-325-2268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 WEIR DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251240",
            "telephone_number": "612-325-2268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODBURY LEADERSHIP ACADEMY 4228-07",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-11",
        "last_updated": "2016-11-17",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "DIRECTOR OF SPECIAL EDUCATION",
        "authorized_official_telephone_number": "612-325-2268"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Woodbury, MN by specialty
• Community/Behavioral Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.