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General NPI Number Information
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NPI Number | 1477870657
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Entity Type | Organization
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Legal Business Name | CULDESAC JOINT SCHOOL DISTRICT #342
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Dates
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Enumeration Date | 04/27/2010
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Last Update Date | 04/27/2010
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Provider Practice Location Address
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Address Line | 600 CULDESAC AVE
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City | CULDESAC
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State | ID
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Zip | 83524-8700
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Country | US
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Telephone | 208-843-5413
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Fax | 208-843-2719
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Provider Business Mailing Address
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Address Line | 600 CULDESAC AVE ATTN: PRINCIPAL HUSSMAN
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City | CULDESAC
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State | ID
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Zip | 83524
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Country | US
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Telephone | 208-843-5413
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Fax | 208-843-2719
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Authorized Official
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Title or Position | SCHOOL PRINCIPAL
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Name | MR. JON HUSSMAN
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Credential |
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Telephone | 208-843-5413
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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 |
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