Organization
DEBEQUE SCHOOL DISTRICT 49JT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUDITH D WICKER (MEDICAID COORDINATOR)
(970) 254-5302
Entity
Organization
Contact information
Practice address
730 MINTER AVE, DEBEQUE, CO 81630
(970) 283-5596
(970) 283-5598
Mailing address
730 MINTER AVE, DEBEQUE, CO 81630
(970) 283-5596
(970) 283-5598
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
UN20529821
—
CO
Enumeration date
11/01/2006
Last updated
08/22/2020
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