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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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