Provider Demographics
NPI:1366652166
Name:COUNTY OF BINGHAM SCHOOL DIST ABERDEEN CLASS A
Entity Type:Organization
Organization Name:COUNTY OF BINGHAM SCHOOL DIST ABERDEEN CLASS A
Other - Org Name:ABERDEEN SCHOOL DISTRICT #58
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SPECIAL EDUCATION DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:VAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-397-4115
Mailing Address - Street 1:382 W WASHINGTON STR.
Mailing Address - Street 2:PO BOX 610
Mailing Address - City:ABERDEEN
Mailing Address - State:ID
Mailing Address - Zip Code:83210
Mailing Address - Country:US
Mailing Address - Phone:208-397-4115
Mailing Address - Fax:208-397-4117
Practice Address - Street 1:382 W WASHINGTON
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:ID
Practice Address - Zip Code:83210
Practice Address - Country:US
Practice Address - Phone:208-397-4115
Practice Address - Fax:208-397-4117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID0028170Medicaid