Provider Demographics
NPI:1295496552
Name:CENTENNIAL PUBLIC SCHOOL
Entity type:Organization
Organization Name:CENTENNIAL PUBLIC SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:TERI
Authorized Official - Middle Name:
Authorized Official - Last Name:FICKEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-534-2321
Mailing Address - Street 1:PO BOX 187
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NE
Mailing Address - Zip Code:68456-0187
Mailing Address - Country:US
Mailing Address - Phone:402-534-2321
Mailing Address - Fax:402-534-2291
Practice Address - Street 1:1301 CENTENNIAL AVE
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NE
Practice Address - Zip Code:68456-6168
Practice Address - Country:US
Practice Address - Phone:402-534-2321
Practice Address - Fax:402-534-2291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-07
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)