Provider Demographics
NPI:1760504989
Name:DIETRICH SCHOOL DISTRICT #314
Entity Type:Organization
Organization Name:DIETRICH SCHOOL DISTRICT #314
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISTRICT CLERK
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:LARSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-544-2158
Mailing Address - Street 1:406 N PARK ST
Mailing Address - Street 2:
Mailing Address - City:DIETRICH
Mailing Address - State:ID
Mailing Address - Zip Code:83324-5069
Mailing Address - Country:US
Mailing Address - Phone:208-544-2158
Mailing Address - Fax:208-544-2832
Practice Address - Street 1:406 N PARK ST
Practice Address - Street 2:
Practice Address - City:DIETRICH
Practice Address - State:ID
Practice Address - Zip Code:83324-5069
Practice Address - Country:US
Practice Address - Phone:208-544-2158
Practice Address - Fax:208-544-2832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)