Provider Demographics
NPI:1093862484
Name:SIOUX CENTER COMMUNITY SCHOOLS
Entity Type:Organization
Organization Name:SIOUX CENTER COMMUNITY SCHOOLS
Other - Org Name:SIOUX CENTER COMMUNITY SCHOOL DISTRICT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERINTENDENT OF SCHOOLS
Authorized Official - Prefix:MR
Authorized Official - First Name:PAT
Authorized Official - Middle Name:
Authorized Official - Last Name:O'DONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-722-2985
Mailing Address - Street 1:550 9TH ST NE
Mailing Address - Street 2:
Mailing Address - City:SIOUX CENTER
Mailing Address - State:IA
Mailing Address - Zip Code:51250-2004
Mailing Address - Country:US
Mailing Address - Phone:712-722-2981
Mailing Address - Fax:712-722-2986
Practice Address - Street 1:550 9TH ST NE
Practice Address - Street 2:
Practice Address - City:SIOUX CENTER
Practice Address - State:IA
Practice Address - Zip Code:51250-2004
Practice Address - Country:US
Practice Address - Phone:712-722-2981
Practice Address - Fax:712-722-2986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0225029Medicaid