Provider Demographics
NPI:1396965521
Name:MAPLETON PUBLIC SCHOOLS ADAMS 1
Entity type:Organization
Organization Name:MAPLETON PUBLIC SCHOOLS ADAMS 1
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAID COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:RODGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-853-1128
Mailing Address - Street 1:7350 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80221-3610
Mailing Address - Country:US
Mailing Address - Phone:303-853-1128
Mailing Address - Fax:303-853-1194
Practice Address - Street 1:7350 BROADWAY
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80221-3610
Practice Address - Country:US
Practice Address - Phone:303-853-1128
Practice Address - Fax:303-853-1194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-30
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO80982824Medicaid