Provider Demographics
NPI:1780875872
Name:LAUREL SCHOOL DISTRICT
Entity type:Organization
Organization Name:LAUREL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSH
Authorized Official - Middle Name:J
Authorized Official - Last Name:MIDDLETON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-628-8623
Mailing Address - Street 1:410 COLORADO AVE
Mailing Address - Street 2:LAUREL PUBLIC SCHOOLS
Mailing Address - City:LAUREL
Mailing Address - State:MT
Mailing Address - Zip Code:59044-2714
Mailing Address - Country:US
Mailing Address - Phone:406-628-8623
Mailing Address - Fax:406-628-8625
Practice Address - Street 1:410 COLORADO AVE
Practice Address - Street 2:LAUREL PUBLIC SCHOOLS
Practice Address - City:LAUREL
Practice Address - State:MT
Practice Address - Zip Code:59044-2714
Practice Address - Country:US
Practice Address - Phone:406-628-8623
Practice Address - Fax:406-628-8625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT0970251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0166660Medicaid