Provider Demographics
NPI:1508932971
Name:ELK POINT JEFFERSON SCHOOL DIST
Entity Type:Organization
Organization Name:ELK POINT JEFFERSON SCHOOL DIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:CHICOINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-356-5960
Mailing Address - Street 1:PO BOX 578
Mailing Address - Street 2:
Mailing Address - City:ELK POINT
Mailing Address - State:SD
Mailing Address - Zip Code:57025
Mailing Address - Country:US
Mailing Address - Phone:605-356-2606
Mailing Address - Fax:605-356-5953
Practice Address - Street 1:402 DOUGLAS
Practice Address - Street 2:
Practice Address - City:ELK POINT
Practice Address - State:SD
Practice Address - Zip Code:57025
Practice Address - Country:US
Practice Address - Phone:605-256-2606
Practice Address - Fax:605-356-5953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
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
SD5150070Medicaid