Provider Demographics
NPI:1912038860
Name:MID-PRAIRIE COMMUNITY SCHOOL
Entity Type:Organization
Organization Name:MID-PRAIRIE COMMUNITY SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUG
Authorized Official - Middle Name:A
Authorized Official - Last Name:SLAUBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-646-6093
Mailing Address - Street 1:1635 HIGHWAY 22 EAST
Mailing Address - Street 2:
Mailing Address - City:WELLMAN
Mailing Address - State:IA
Mailing Address - Zip Code:52356-0150
Mailing Address - Country:US
Mailing Address - Phone:319-646-6093
Mailing Address - Fax:319-646-2093
Practice Address - Street 1:1635 HIGHWAY 22 EAST
Practice Address - Street 2:
Practice Address - City:WELLMAN
Practice Address - State:IA
Practice Address - Zip Code:52356-0150
Practice Address - Country:US
Practice Address - Phone:319-646-6093
Practice Address - Fax:319-646-2093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0457804Medicaid