Provider Demographics
NPI:1093989584
Name:FRAZER SCHOOL DISTRICT
Entity Type:Organization
Organization Name:FRAZER SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:H
Authorized Official - Last Name:MAVENCAMP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-695-2241
Mailing Address - Street 1:325 6TH STREET
Mailing Address - Street 2:
Mailing Address - City:FRAZER
Mailing Address - State:MT
Mailing Address - Zip Code:59225
Mailing Address - Country:US
Mailing Address - Phone:406-695-2241
Mailing Address - Fax:406-695-2243
Practice Address - Street 1:325 6TH STREET
Practice Address - Street 2:
Practice Address - City:FRAZER
Practice Address - State:MT
Practice Address - Zip Code:59225
Practice Address - Country:US
Practice Address - Phone:406-695-2241
Practice Address - Fax:406-695-2243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0165659Medicaid