Provider Demographics
NPI:1417095365
Name:EL PASO COUNTY SCHOOL DISTRICT 12
Entity Type:Organization
Organization Name:EL PASO COUNTY SCHOOL DISTRICT 12
Other - Org Name:CHEYENNE MOUNTAIN 12
Other - Org Type:Other Name
Authorized Official - Title/Position:EXEC. DIRECTOR OF BUSINESS SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-475-6100
Mailing Address - Street 1:1775 LACLEDE STREET
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80905-9502
Mailing Address - Country:US
Mailing Address - Phone:719-475-6100
Mailing Address - Fax:719-475-9502
Practice Address - Street 1:1775 LACLEDE STREET
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80905-9502
Practice Address - Country:US
Practice Address - Phone:719-475-6100
Practice Address - Fax:719-475-9502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO81900546Medicaid