Healthcare Provider Details

I. General information

NPI: 1871822395
Provider Name (Legal Business Name): COLO NESCO COMM SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2009
Last Update Date: 12/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 LATROBE AVE PO BOX B
MC CALLSBURG IA
50154-7714
US

IV. Provider business mailing address

400 LATROBE AVE PO BOX B
MC CALLSBURG IA
50154-7714
US

V. Phone/Fax

Practice location:
  • Phone: 515-434-2320
  • Fax:
Mailing address:
  • Phone: 515-434-2320
  • Fax:

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: MR. GARY PILLMAN
Title or Position: SUPERINTENDENT
Credential:
Phone: 515-434-2320