Provider Demographics
NPI:1376608109
Name:COUNTY OF LEWIS & CLARK LEWIS & CLARK COUNTY SCHOOL DISTRICT #1
Entity Type:Organization
Organization Name:COUNTY OF LEWIS & CLARK LEWIS & CLARK COUNTY SCHOOL DISTRICT #1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JANELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MICKELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-324-2040
Mailing Address - Street 1:1325 POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-0938
Mailing Address - Country:US
Mailing Address - Phone:406-324-2042
Mailing Address - Fax:406-324-3018
Practice Address - Street 1:1325 POPLAR ST
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-0938
Practice Address - Country:US
Practice Address - Phone:406-324-2042
Practice Address - Fax:406-324-3018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT970869251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0160862Medicaid
MT0164450Medicaid
MT0380432Medicaid
MT0160293Medicaid
MT0160310Medicaid
MT0164492Medicaid