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General NPI Number Information
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NPI Number | 1922194125
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Entity Type | Organization
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Legal Business Name | CENTER CONSOLIDATED SCHOOL DISTRICT 2654
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 500 S BROADWAY
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City | CENTER
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State | CO
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Zip | 81125
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Country | US
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Telephone | 719-754-3442
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Fax | 719-754-3952
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Provider Business Mailing Address
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Address Line | 500 S BROADWAY
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City | CENTER
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State | CO
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Zip | 81125
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Country | US
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Telephone | 719-754-3442
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Fax | 719-754-3952
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MR. SEAN J MONROE
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Credential |
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Telephone | 719-754-3442
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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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