Provider Demographics
NPI:1063652477
Name:SHANNON COUNTY SCHOOLS
Entity Type:Organization
Organization Name:SHANNON COUNTY SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MADONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-288-1921
Mailing Address - Street 1:PO BOX 109
Mailing Address - Street 2:
Mailing Address - City:BATESLAND
Mailing Address - State:SD
Mailing Address - Zip Code:57716-0109
Mailing Address - Country:US
Mailing Address - Phone:605-288-1921
Mailing Address - Fax:605-288-1814
Practice Address - Street 1:206 SCHOOL ST.
Practice Address - Street 2:
Practice Address - City:BATESLAND
Practice Address - State:SD
Practice Address - Zip Code:57716-0109
Practice Address - Country:US
Practice Address - Phone:605-288-1921
Practice Address - Fax:605-288-1814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-25
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty