Provider Demographics
NPI:1013240415
Name:USD 454BURLINGAME PUBLIC
Entity Type:Organization
Organization Name:USD 454BURLINGAME PUBLIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KONICEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-654-3328
Mailing Address - Street 1:100 BLOOMQUIST DR STE A
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:KS
Mailing Address - Zip Code:66413-1527
Mailing Address - Country:US
Mailing Address - Phone:785-654-3328
Mailing Address - Fax:
Practice Address - Street 1:100 BLOOMQUIST DR STE A
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:KS
Practice Address - Zip Code:66413-1527
Practice Address - Country:US
Practice Address - Phone:785-654-3328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THREE LAKES EDUCATION COOP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-09-16
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)