Provider Demographics
NPI:1205039906
Name:COLLIER COUNTY SCHOOL BOARD
Entity Type:Organization
Organization Name:COLLIER COUNTY SCHOOL BOARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ESE ITS MEDICAID
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-377-0153
Mailing Address - Street 1:5775 OSCEOLA TRL
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-0919
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5775 OSCEOLA TRL
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-0919
Practice Address - Country:US
Practice Address - Phone:239-377-0153
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)