Provider Demographics
NPI:1265587042
Name:JOHNSTON CSD
Entity type:Organization
Organization Name:JOHNSTON CSD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, SPECIAL EDUCATION
Authorized Official - Prefix:MS
Authorized Official - First Name:VICKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCOOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-278-0335
Mailing Address - Street 1:PO BOX 10
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-0010
Mailing Address - Country:US
Mailing Address - Phone:515-278-0335
Mailing Address - Fax:515-278-6303
Practice Address - Street 1:5608 MERLE HAY RD.
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-1213
Practice Address - Country:US
Practice Address - Phone:515-278-0335
Practice Address - Fax:515-278-6303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
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
IA0427039Medicaid