Organization
FREMONT JOINT SCHOOL DISTRICT #215
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
147 2ND W STREET, ST. ANTHONY, ID 83445
(208) 624-3146
(208) 624-3442
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
—
805096000
—
ID
Enumeration date
01/23/2007
Last updated
06/19/2008
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