Provider Demographics
NPI:1518093848
Name:CASSIA JOINT SCHOOL DISTRICT #151
Entity Type:Organization
Organization Name:CASSIA JOINT SCHOOL DISTRICT #151
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAID SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUNE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BYLUND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-878-6627
Mailing Address - Street 1:237 E 19TH ST
Mailing Address - Street 2:
Mailing Address - City:BURLEY
Mailing Address - State:ID
Mailing Address - Zip Code:83318-2444
Mailing Address - Country:US
Mailing Address - Phone:208-878-6627
Mailing Address - Fax:208-878-3395
Practice Address - Street 1:237 E 19TH ST
Practice Address - Street 2:
Practice Address - City:BURLEY
Practice Address - State:ID
Practice Address - Zip Code:83318-2444
Practice Address - Country:US
Practice Address - Phone:208-878-6627
Practice Address - Fax:208-878-3395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID208D00000X251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)