Provider Demographics
NPI:1659478923
Name:UNIFIED SCHOOL DISTRICT 259
Entity Type:Organization
Organization Name:UNIFIED SCHOOL DISTRICT 259
Other - Org Name:SPECIAL EDUCATION DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAID BILLING TECHNICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:M
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-973-4710
Mailing Address - Street 1:201 N WATER ST
Mailing Address - Street 2:SPECIAL ED DEPT
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67202-1292
Mailing Address - Country:US
Mailing Address - Phone:316-973-4710
Mailing Address - Fax:
Practice Address - Street 1:201 N WATER ST
Practice Address - Street 2:SPECIAL ED DEPT
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67202-1292
Practice Address - Country:US
Practice Address - Phone:316-973-4710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251300000X
KS261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
No261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100211950AMedicaid