Provider Demographics
NPI:1336572775
Name:POWDER RIVER COUNTY DISTRICT HIGH SCHOOL
Entity Type:Organization
Organization Name:POWDER RIVER COUNTY DISTRICT HIGH SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-436-2658
Mailing Address - Street 1:500 N TRAUTMAN
Mailing Address - Street 2:
Mailing Address - City:BROADUS
Mailing Address - State:MT
Mailing Address - Zip Code:59317-0500
Mailing Address - Country:US
Mailing Address - Phone:406-436-2658
Mailing Address - Fax:406-436-2660
Practice Address - Street 1:500 N TRAUTMAN
Practice Address - Street 2:
Practice Address - City:BROADUS
Practice Address - State:MT
Practice Address - Zip Code:59317-0500
Practice Address - Country:US
Practice Address - Phone:406-436-2658
Practice Address - Fax:406-436-2660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-20
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)