MEDICARE: DALLAS CENTER-GRIMES CSD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841347135
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DALLAS CENTER-GRIMES CSD

Provider Business Mailing Address
First Line	:	PO BOX 512
Second Line	:
City	:	DALLAS CENTER
State	:	IA
Zip	:	50063-0512
Country	:	US
Telephone Number	:	515-992-3866
Fax Number	:	515-992-3079

Provider Business Practice Location Address
First Line	:	1414 WALNUT STREET
Second Line	:
City	:	DALLAS CENTER
State	:	IA
Zip	:	50063-0512
Country	:	US
Telephone Number	:	515-992-3866
Fax Number	:	515-992-3079

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	GARY SINCLAIR
Credential	:
Telephone Number	:	515-992-3866

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	08/22/2020

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