Provider Demographics
NPI:1962682781
Name:LEAD-DEADWOOD SCHOOL DISTRICT
Entity Type:Organization
Organization Name:LEAD-DEADWOOD SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RANTAPAA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-717-3890
Mailing Address - Street 1:320 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEAD
Mailing Address - State:SD
Mailing Address - Zip Code:57754-1559
Mailing Address - Country:US
Mailing Address - Phone:605-717-3890
Mailing Address - Fax:605-717-2813
Practice Address - Street 1:320 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LEAD
Practice Address - State:SD
Practice Address - Zip Code:57754-1559
Practice Address - Country:US
Practice Address - Phone:605-717-3890
Practice Address - Fax:605-717-2813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD5150930251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5150930Medicaid