Healthcare Provider Details

I. General information

NPI: 1760404966
Provider Name (Legal Business Name): SILVER LAKE USD 372
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 08/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 RICE ROAD
SILVER LAKE KS
66539-0039
US

IV. Provider business mailing address

PO BOX 189
GIRARD KS
66743-0189
US

V. Phone/Fax

Practice location:
  • Phone: 785-582-4026
  • Fax: 785-582-5259
Mailing address:
  • Phone: 620-724-6281
  • Fax: 620-724-7141

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: DEB HOWSER
Title or Position: DIRECTOR
Credential:
Phone: 785-582-4026