Provider Demographics
NPI:1447772538
Name:IDAHO TECHNICAL CAREER ACADEMY
Entity Type:Organization
Organization Name:IDAHO TECHNICAL CAREER ACADEMY
Other - Org Name:IDAHO COLLEGE AND CAREER READINESS ACADEMY, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:SPECIAL SERVICES ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:JUDD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-995-4904
Mailing Address - Street 1:1965 S EAGLE RD STE 150
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-9287
Mailing Address - Country:US
Mailing Address - Phone:208-917-2420
Mailing Address - Fax:
Practice Address - Street 1:1965 S EAGLE RD STE 150
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-9287
Practice Address - Country:US
Practice Address - Phone:208-917-2420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)