Provider Demographics
NPI:1982763256
Name:MORGAN COUNTY DISTRICT RE2J
Entity Type:Organization
Organization Name:MORGAN COUNTY DISTRICT RE2J
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:MILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-842-5176
Mailing Address - Street 1:PO BOX 585 INDUSTRIAL ROAD
Mailing Address - Street 2:
Mailing Address - City:BRUSH
Mailing Address - State:CO
Mailing Address - Zip Code:80723
Mailing Address - Country:US
Mailing Address - Phone:970-842-5176
Mailing Address - Fax:970-842-4481
Practice Address - Street 1:527 INDUSTRIAL PARK RD
Practice Address - Street 2:
Practice Address - City:BRUSH
Practice Address - State:CO
Practice Address - Zip Code:80723-2914
Practice Address - Country:US
Practice Address - Phone:970-842-5176
Practice Address - Fax:970-842-4481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO55320058Medicaid