Healthcare Provider Details

I. General information

NPI: 1023724754
Provider Name (Legal Business Name): COUNTY OF DAWSON COZAD CITY SCHOOLS DISTRICT 011
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2023
Last Update Date: 01/26/2023
Certification Date: 01/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 MERIDIAN AVE
COZAD NE
69130-1159
US

IV. Provider business mailing address

1910 MERIDIAN AVE
COZAD NE
69130-1159
US

V. Phone/Fax

Practice location:
  • Phone: 308-784-2745
  • Fax:
Mailing address:
  • Phone: 308-784-2745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES M FORD
Title or Position: INTERIM SUPERINTENDENT
Credential: MD
Phone: 308-784-2745