Provider Demographics
NPI:1164621256
Name:JEFFERSON-SCRANTON COMMUNITY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:JEFFERSON-SCRANTON COMMUNITY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-386-4168
Mailing Address - Street 1:204 W MADISON ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:IA
Mailing Address - Zip Code:50129-2129
Mailing Address - Country:US
Mailing Address - Phone:515-386-4168
Mailing Address - Fax:515-386-3591
Practice Address - Street 1:204 W MADISON ST
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:IA
Practice Address - Zip Code:50129-2129
Practice Address - Country:US
Practice Address - Phone:515-386-4168
Practice Address - Fax:515-386-3591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0200391Medicaid