Provider Demographics
NPI:1558442053
Name:CHERRY CREEK SCHOOL DISTRICT NO. 5
Entity Type:Organization
Organization Name:CHERRY CREEK SCHOOL DISTRICT NO. 5
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL AND OPERATING OFC
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-358-0851
Mailing Address - Street 1:4850 S YOSEMITE ST
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-1308
Mailing Address - Country:US
Mailing Address - Phone:720-886-7057
Mailing Address - Fax:720-886-7059
Practice Address - Street 1:4850 S YOSEMITE ST
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-1308
Practice Address - Country:US
Practice Address - Phone:720-886-7057
Practice Address - Fax:720-886-7059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
COUM04444162Medicaid