Provider Demographics
NPI:1861663452
Name:SANBORN CENTRAL SCHOOL DISTRICT
Entity Type:Organization
Organization Name:SANBORN CENTRAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL SERVICES LEA
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-995-3021
Mailing Address - Street 1:40405 SD HWY 34
Mailing Address - Street 2:
Mailing Address - City:FORESTBURG
Mailing Address - State:SD
Mailing Address - Zip Code:57314-6421
Mailing Address - Country:US
Mailing Address - Phone:605-495-4183
Mailing Address - Fax:605-495-4185
Practice Address - Street 1:40405 SD HWY 34
Practice Address - Street 2:
Practice Address - City:FORESTBURG
Practice Address - State:SD
Practice Address - Zip Code:57314-6421
Practice Address - Country:US
Practice Address - Phone:605-495-4183
Practice Address - Fax:605-495-4185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-21
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5152450Medicare PIN