Provider Demographics
NPI:1518088178
Name:POCATELLO CHUBBUCK SCHOOL DISTRICT #25
Entity Type:Organization
Organization Name:POCATELLO CHUBBUCK SCHOOL DISTRICT #25
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL EDUCATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:D
Authorized Official - Last Name:STEENROD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-232-3563
Mailing Address - Street 1:3115 POLE LINE RD
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201-6119
Mailing Address - Country:US
Mailing Address - Phone:208-232-3563
Mailing Address - Fax:208-235-3280
Practice Address - Street 1:3115 POLE LINE RD
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83201-6119
Practice Address - Country:US
Practice Address - Phone:208-232-3563
Practice Address - Fax:208-235-3280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)