Provider Demographics
NPI:1457489338
Name:LAMAR SCHOOL DISTRICT RE 2
Entity Type:Organization
Organization Name:LAMAR SCHOOL DISTRICT RE 2
Other - Org Name:LAMAR SCHOOL DISTRICT
Other - Org Type:Other Name
Authorized Official - Title/Position:SUPERINTENDENT OF SCHOOLS
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:TECKLENBURG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-336-3251
Mailing Address - Street 1:210 W PEARL ST
Mailing Address - Street 2:
Mailing Address - City:LAMAR
Mailing Address - State:CO
Mailing Address - Zip Code:81052-3163
Mailing Address - Country:US
Mailing Address - Phone:719-336-3251
Mailing Address - Fax:
Practice Address - Street 1:210 W PEARL ST
Practice Address - Street 2:
Practice Address - City:LAMAR
Practice Address - State:CO
Practice Address - Zip Code:81052-3163
Practice Address - Country:US
Practice Address - Phone:719-336-3251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO38838869Medicaid