Provider Demographics
NPI:1205052768
Name:OLYMPIA CUSD 16
Entity type:Organization
Organization Name:OLYMPIA CUSD 16
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DON
Authorized Official - Middle Name:
Authorized Official - Last Name:HAHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-379-6011
Mailing Address - Street 1:903 E 800 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61774-9612
Mailing Address - Country:US
Mailing Address - Phone:309-379-6011
Mailing Address - Fax:309-379-2328
Practice Address - Street 1:903 E 800 NORTH RD
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:IL
Practice Address - Zip Code:61774-9612
Practice Address - Country:US
Practice Address - Phone:309-379-6011
Practice Address - Fax:309-379-2328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
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
IL=========001Medicaid