Provider Demographics
NPI:1104013424
Name:DEUBROOK AREA SCHOOL DIST 5 6
Entity Type:Organization
Organization Name:DEUBROOK AREA SCHOOL DIST 5 6
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-629-1102
Mailing Address - Street 1:PO BOX 346
Mailing Address - Street 2:
Mailing Address - City:WHITE
Mailing Address - State:SD
Mailing Address - Zip Code:57276-0346
Mailing Address - Country:US
Mailing Address - Phone:605-629-1102
Mailing Address - Fax:605-629-3701
Practice Address - Street 1:100 SCHOOL AVE
Practice Address - Street 2:
Practice Address - City:WHITE
Practice Address - State:SD
Practice Address - Zip Code:57276-0346
Practice Address - Country:US
Practice Address - Phone:605-629-1102
Practice Address - Fax:605-629-3701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5150340Medicaid