Provider Demographics
NPI:1972678423
Name:BROOKINGS SCHOOL DISTRICT 5-1
Entity Type:Organization
Organization Name:BROOKINGS SCHOOL DISTRICT 5-1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ORVILLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CREIGHTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-696-4700
Mailing Address - Street 1:2130 8TH ST S
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57006-3507
Mailing Address - Country:US
Mailing Address - Phone:605-696-4700
Mailing Address - Fax:605-696-4704
Practice Address - Street 1:2130 8TH ST S
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:SD
Practice Address - Zip Code:57006-3507
Practice Address - Country:US
Practice Address - Phone:605-696-4700
Practice Address - Fax:605-696-4704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
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
SD5152030Medicaid