Provider Demographics
NPI:1598812448
Name:BOONE C.S.D.
Entity Type:Organization
Organization Name:BOONE C.S.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THELON
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHUTTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-433-0750
Mailing Address - Street 1:500 7TH ST
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:IA
Mailing Address - Zip Code:50036-2838
Mailing Address - Country:US
Mailing Address - Phone:515-433-0750
Mailing Address - Fax:
Practice Address - Street 1:500 7TH ST
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:IA
Practice Address - Zip Code:50036-2838
Practice Address - Country:US
Practice Address - Phone:515-433-0750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
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
IA0269191Medicaid