Provider Demographics
NPI:1053462754
Name:SHENANDOAH COMMUNITY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:SHENANDOAH COMMUNITY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DICK
Authorized Official - Middle Name:
Authorized Official - Last Name:PROFIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-246-1581
Mailing Address - Street 1:304 W NISHNA RD
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:IA
Mailing Address - Zip Code:51601-2312
Mailing Address - Country:US
Mailing Address - Phone:712-246-1581
Mailing Address - Fax:712-246-3722
Practice Address - Street 1:601 DR CREIGHTON CIR
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:IA
Practice Address - Zip Code:51601-2634
Practice Address - Country:US
Practice Address - Phone:712-246-2520
Practice Address - Fax:712-246-6390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)