Provider Demographics
NPI:1235287780
Name:JUNEAU SCHOOL DISTRICT
Entity Type:Organization
Organization Name:JUNEAU SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF STUDENT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:MAX
Authorized Official - Last Name:KUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-523-1750
Mailing Address - Street 1:10014 CRAZY HORSE DR
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-8529
Mailing Address - Country:US
Mailing Address - Phone:907-523-1753
Mailing Address - Fax:
Practice Address - Street 1:10014 CRAZY HORSE DR
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-8529
Practice Address - Country:US
Practice Address - Phone:907-523-1753
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
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
AKSB0101Medicaid