Provider Demographics
NPI:1497804272
Name:SOUTH TAMA COUNTY COMMUNITY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:SOUTH TAMA COUNTY COMMUNITY SCHOOL DISTRICT
Other - Org Name:AREA EDUCATION AGENCY 267
Other - Org Type:Other Name
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLACEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-484-4811
Mailing Address - Street 1:1702 HARDING ST
Mailing Address - Street 2:
Mailing Address - City:TAMA
Mailing Address - State:IA
Mailing Address - Zip Code:52339-1028
Mailing Address - Country:US
Mailing Address - Phone:641-484-4811
Mailing Address - Fax:641-484-4861
Practice Address - Street 1:1702 HARDING ST
Practice Address - Street 2:
Practice Address - City:TAMA
Practice Address - State:IA
Practice Address - Zip Code:52339-1028
Practice Address - Country:US
Practice Address - Phone:641-484-4811
Practice Address - Fax:641-484-4861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0434571Medicaid