Healthcare Provider Details

I. General information

NPI: 1053469114
Provider Name (Legal Business Name): URBANDALE COMMUNITY SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 05/07/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11152 AURORA AVE
URBANDALE IA
50322
US

IV. Provider business mailing address

11152 AURORA AVE
URBANDALE IA
50322
US

V. Phone/Fax

Practice location:
  • Phone: 515-457-5000
  • Fax:
Mailing address:
  • Phone: 515-457-5000
  • Fax: 515-457-5018

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: STEVEN M RICHMAN
Title or Position: DIRECTOR OF BUSINESS SERVICES
Credential:
Phone: 515-457-5003