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General NPI Number Information
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NPI Number | 1326192949
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Entity Type | Organization
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Legal Business Name | COUNTY OF GOODING SCHOOL DIST 231 CLASS A
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 507 IDAHO ST
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City | GOODING
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State | ID
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Zip | 83330-1260
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Country | US
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Telephone | 208-934-9345
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Fax | 208-934-4403
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Provider Business Mailing Address
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Address Line | 104 E FAIRVIEW AVE STE 201
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City | MERIDIAN
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State | ID
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Zip | 83642-1733
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Country | US
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Telephone | 208-922-3093
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Fax | 208-922-9351
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Authorized Official
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Title or Position | SYSTEMS MANAGER
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Name | MR. TODD KENNETH LEVESQUE
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Credential |
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Telephone | 208-922-3093
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State | ID
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