Organization
CULDESAC JOINT SCHOOL DISTRICT #342
Active
Other names
County of Nezperce
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JON HUSSMAN (SCHOOL PRINCIPAL)
(208) 843-5413
Entity
Organization
Contact information
Practice address
600 CULDESAC AVE, CULDESAC, ID 83524-8700
(208) 843-5413
(208) 843-2719
Mailing address
600 CULDESAC AVE, ATTN: PRINCIPAL HUSSMAN, CULDESAC, ID 83524
(208) 843-5413
(208) 843-2719
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
805102000
IDAHO MEDICAID PROVIDER NUMBER
ID
Enumeration date
04/27/2010
Last updated
04/27/2010
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