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General NPI Number Information
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NPI Number | 1689758930
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Entity Type | Organization
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Legal Business Name | JEFFERSON COUNTY SCHOOL DISTRICT R-1
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 03/15/2021
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Provider Practice Location Address
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Address Line | 1829 DENVER WEST DR BLDG 27
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City | GOLDEN
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State | CO
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Zip | 80401-3120
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Country | US
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Telephone | 303-982-6500
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Fax |
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Provider Business Mailing Address
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Address Line | 1829 DENVER WEST DR BLDG 27
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City | GOLDEN
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State | CO
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Zip | 80401-3120
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Country | US
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Telephone | 303-982-6500
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Fax |
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Authorized Official
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Title or Position | COORDINATOR, SCHOOL MEDICAID PROGRA
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Name | KATHRYN RENEE HETZEL
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Credential |
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Telephone | 303-982-4502
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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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