Healthcare Provider Details

I. General information

NPI: 1386708246
Provider Name (Legal Business Name): AREA EDUCATION AGENCY 267
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3712 CEDAR HEIGHTS DR
CEDAR FALLS IA
50613-6207
US

IV. Provider business mailing address

3712 CEDAR HEIGHTS DR
CEDAR FALLS IA
50613-6207
US

V. Phone/Fax

Practice location:
  • Phone: 319-273-8250
  • Fax: 319-273-8275
Mailing address:
  • Phone: 319-273-8250
  • Fax: 319-273-8275

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0421321
Identifier TypeMEDICAID
Identifier StateIA
Identifier Issuer

VIII. Authorized Official

Name: MARY STEVENS
Title or Position: DIRECTOR OF SPECIAL EDUCATION
Credential:
Phone: 319-273-8250