Provider Demographics
NPI:1013789346
Name:BISMARCK PUBLIC SCHOOLS CARE COORDINATION
Entity Type:Organization
Organization Name:BISMARCK PUBLIC SCHOOLS CARE COORDINATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:FASTNACHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-323-4000
Mailing Address - Street 1:128 SOO LINE DR
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-3339
Mailing Address - Country:US
Mailing Address - Phone:701-323-4000
Mailing Address - Fax:
Practice Address - Street 1:128 SOO LINE DR
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-3339
Practice Address - Country:US
Practice Address - Phone:701-323-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management