Provider Demographics
NPI:1720295041
Name:BUTTE PUBLIC SCHOOLS
Entity Type:Organization
Organization Name:BUTTE PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:CANNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-533-2969
Mailing Address - Street 1:1050 S MONTANA ST
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-2840
Mailing Address - Country:US
Mailing Address - Phone:406-533-2969
Mailing Address - Fax:406-533-2980
Practice Address - Street 1:1050 S MONTANA ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-2840
Practice Address - Country:US
Practice Address - Phone:406-533-2969
Practice Address - Fax:406-533-2969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2012-09-12
Deactivation Date:2008-08-20
Deactivation Code:
Reactivation Date:2009-04-06
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT165274Medicaid
MT166277Medicaid