Provider Demographics
NPI:1083744627
Name:CROWLEY COUNTY SCHOOL DISTRICT RE-1-J
Entity Type:Organization
Organization Name:CROWLEY COUNTY SCHOOL DISTRICT RE-1-J
Other - Org Name:CROWLEY SCHOOL DISTRICT
Other - Org Type:Other Name
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:MUMM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-267-3117
Mailing Address - Street 1:117 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:ORDWAY
Mailing Address - State:CO
Mailing Address - Zip Code:81063-1101
Mailing Address - Country:US
Mailing Address - Phone:719-267-3117
Mailing Address - Fax:
Practice Address - Street 1:117 W 3RD ST
Practice Address - Street 2:
Practice Address - City:ORDWAY
Practice Address - State:CO
Practice Address - Zip Code:81063-1101
Practice Address - Country:US
Practice Address - Phone:719-267-3117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO62538292Medicaid