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Organization
COUNTY OF CARIBOU IND SCHOOL DIST 149
Active
Organization
COUNTY OF CARIBOU IND SCHOOL DIST 149
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TODD KENNETH LEVESQUE (SYSTEMS MANAGER)
(208) 922-3093
Entity
Organization
Contact information
Practice address
322 SOUTH MAIN STREET, BANCROFT, ID 83217
(208) 648-7848
(208) 648-7895
Mailing address
104 E FAIRVIEW AVE STE 201, MERIDIAN, ID 83642-1733
(208) 922-3093
(208) 922-9351
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805634400
—
ID
Enumeration date
02/13/2007
Last updated
07/07/2008
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