Provider Demographics
NPI:1245416130
Name:MCCALL-DONNELLY JOINT SCHOOL DISTRICT 421
Entity Type:Organization
Organization Name:MCCALL-DONNELLY JOINT SCHOOL DISTRICT 421
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SYSTEMS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:LEVESQUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-922-3093
Mailing Address - Street 1:120 IDAHO ST
Mailing Address - Street 2:
Mailing Address - City:MCCALL
Mailing Address - State:ID
Mailing Address - Zip Code:83638-3826
Mailing Address - Country:US
Mailing Address - Phone:208-634-2161
Mailing Address - Fax:208-634-4075
Practice Address - Street 1:401 N MISSION ST
Practice Address - Street 2:
Practice Address - City:MCCALL
Practice Address - State:ID
Practice Address - Zip Code:83638-3829
Practice Address - Country:US
Practice Address - Phone:208-634-2218
Practice Address - Fax:208-634-7505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)