Provider Demographics
NPI:1124181771
Name:CENTRAL COMMUNITY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:CENTRAL COMMUNITY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RODENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-245-1751
Mailing Address - Street 1:400 1ST ST NW
Mailing Address - Street 2:P.O. BOX 70
Mailing Address - City:ELKADER
Mailing Address - State:IA
Mailing Address - Zip Code:52043-9061
Mailing Address - Country:US
Mailing Address - Phone:563-245-1751
Mailing Address - Fax:563-245-1763
Practice Address - Street 1:400 1ST ST NW
Practice Address - Street 2:
Practice Address - City:ELKADER
Practice Address - State:IA
Practice Address - Zip Code:52043-9061
Practice Address - Country:US
Practice Address - Phone:563-245-1751
Practice Address - Fax:563-245-1763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
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
IA0422121Medicaid