Provider Demographics
NPI:1134282726
Name:DENISON COMMUNITY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:DENISON COMMUNITY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:STRUCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-263-2176
Mailing Address - Street 1:819 N 16TH ST
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:IA
Mailing Address - Zip Code:51442-1051
Mailing Address - Country:US
Mailing Address - Phone:712-263-2176
Mailing Address - Fax:712-263-5233
Practice Address - Street 1:819 N 16TH ST
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:IA
Practice Address - Zip Code:51442-1051
Practice Address - Country:US
Practice Address - Phone:712-263-2176
Practice Address - Fax:712-263-5233
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 Licenses
StateLicense IDTaxonomies
IA0476952251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0476952Medicaid