Healthcare Provider Details

I. General information

NPI: 1194947358
Provider Name (Legal Business Name): BUTTE COUNTY SCHOOL DISTRICT 111
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

246 SUNSET DRIVE
ARCO ID
83213
US

IV. Provider business mailing address

246 SUNSET DRIVE
ARCO ID
83213
US

V. Phone/Fax

Practice location:
  • Phone: 208-527-8235
  • Fax: 208-527-8950
Mailing address:
  • Phone: 208-527-8235
  • Fax: 208-527-8950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MRS. JULIE HANEY
Title or Position: EXECUTIVE SECRETARY
Credential:
Phone: 208-527-8235