Provider Demographics
NPI:1669500765
Name:LA PLATA COUNTY SCHOOL DISTRICT 10 JT-R
Entity Type:Organization
Organization Name:LA PLATA COUNTY SCHOOL DISTRICT 10 JT-R
Other - Org Name:BAYFIELD SCHOOL DISTRICT
Other - Org Type:Other Name
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:LYONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-884-2496
Mailing Address - Street 1:24 S CLOVER LN
Mailing Address - Street 2:
Mailing Address - City:BAYFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:81122-8761
Mailing Address - Country:US
Mailing Address - Phone:970-884-2496
Mailing Address - Fax:
Practice Address - Street 1:24 S CLOVER LN
Practice Address - Street 2:
Practice Address - City:BAYFIELD
Practice Address - State:CO
Practice Address - Zip Code:81122-8761
Practice Address - Country:US
Practice Address - Phone:970-884-2496
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO44922833Medicaid