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General NPI Number Information
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NPI Number | 1679427694
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Entity Type | Organization
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Legal Business Name | CLEARWATER VALLEY SCHOOL DISTRICT #245
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Dates
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Enumeration Date | 02/25/2026
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Last Update Date | 02/25/2026
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Provider Practice Location Address
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Address Line | 4643 HIGHWAY 13
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City | KOOSKIA
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State | ID
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Zip | 83539-5062
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Country | US
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Telephone | 208-926-4511
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Fax |
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Provider Business Mailing Address
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Address Line | 4643 HIGHWAY 13
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City | KOOSKIA
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State | ID
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Zip | 83539-5062
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Country | US
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Telephone | 208-926-4511
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Fax |
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Authorized Official
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Title or Position | DIRECTOR SPECIAL EDUCATION
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Name | CHARLOTTE MCKINNEY
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Credential | MED
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Telephone | 208-926-4511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number |
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License Number State |
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