Provider Demographics
NPI:1811091820
Name:COLORADO SPRINGS SCHOOL DISTRICT 11
Entity type:Organization
Organization Name:COLORADO SPRINGS SCHOOL DISTRICT 11
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAID COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:RIENKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-520-2251
Mailing Address - Street 1:1115 N EL PASO STREET
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903
Mailing Address - Country:US
Mailing Address - Phone:719-520-2000
Mailing Address - Fax:719-520-2198
Practice Address - Street 1:1115 N EL PASO STREET
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903
Practice Address - Country:US
Practice Address - Phone:719-520-2000
Practice Address - Fax:719-520-2198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-11
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO32030282Medicaid