Provider Demographics
NPI:1336212794
Name:SARGENT SCHOOL DISTRICT RE 33J
Entity Type:Organization
Organization Name:SARGENT SCHOOL DISTRICT RE 33J
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISTRICT BOOKKEEPER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:D
Authorized Official - Last Name:QUINTANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-852-4023
Mailing Address - Street 1:7090 N RD 2 EAST
Mailing Address - Street 2:
Mailing Address - City:MONTE VISTA
Mailing Address - State:CO
Mailing Address - Zip Code:81144
Mailing Address - Country:US
Mailing Address - Phone:719-852-4023
Mailing Address - Fax:
Practice Address - Street 1:7090 N RD 2 EAST
Practice Address - Street 2:
Practice Address - City:MONTE VISTA
Practice Address - State:CO
Practice Address - Zip Code:81144
Practice Address - Country:US
Practice Address - Phone:719-852-4023
Practice Address - Fax:719-852-9890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
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
CO44533268Medicaid