Healthcare Provider Details

I. General information

NPI: 1922298660
Provider Name (Legal Business Name): EAGLE GROVE COMMUNITY SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2007
Last Update Date: 07/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 N COMMERCIAL AVE
EAGLE GROVE IA
50533-1316
US

IV. Provider business mailing address

325 N COMMERCIAL AVE
EAGLE GROVE IA
50533-1316
US

V. Phone/Fax

Practice location:
  • Phone: 515-448-4749
  • Fax: 515-448-3156
Mailing address:
  • Phone: 515-448-4749
  • Fax: 515-448-3156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. TERESA SADLER
Title or Position: BUSINESS MANAGER
Credential:
Phone: 515-448-4749