Provider Demographics
NPI:1659432433
Name:COUNTY OF YELLOWSTONE
Entity Type:Organization
Organization Name:COUNTY OF YELLOWSTONE
Other - Org Name:LOCKWOOD SD NO 26
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-252-6022
Mailing Address - Street 1:1932 US HIGHWAY 87 RT 2
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-6651
Mailing Address - Country:US
Mailing Address - Phone:406-252-6022
Mailing Address - Fax:406-259-2502
Practice Address - Street 1:1932 US HIGHWAY 87 RT 2
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-6651
Practice Address - Country:US
Practice Address - Phone:406-252-6022
Practice Address - Fax:406-259-2502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT165461Medicaid