Provider Demographics
NPI:1356646319
Name:CLAYTON RIDGE CSD
Entity Type:Organization
Organization Name:CLAYTON RIDGE CSD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-252-2341
Mailing Address - Street 1:PO BOX 520
Mailing Address - Street 2:
Mailing Address - City:GUTTENBERG
Mailing Address - State:IA
Mailing Address - Zip Code:52052-0520
Mailing Address - Country:US
Mailing Address - Phone:563-252-2341
Mailing Address - Fax:563-252-2656
Practice Address - Street 1:131 S RIVER PARK DR
Practice Address - Street 2:
Practice Address - City:GUTTENBERG
Practice Address - State:IA
Practice Address - Zip Code:52052-7716
Practice Address - Country:US
Practice Address - Phone:563-252-2341
Practice Address - Fax:563-252-2656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-21
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)