Mullan School District

Primary specialty

Local Education Agency (LEA)Taxonomy code 251300000X

Legal business name

MULLAN SCHOOL DISTRICT

Practice address

345 Park Ave
208-752-8221
Mullan, ID 83846-0071

Phone

(208) 783-2870

Fax

(208) 752-8221

NPI assigned

Feb 28, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Todd Kenneth Levesque

Title

Systems Manager

Phone

(208) 922-3093

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356479760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 E FAIRVIEW AVE STE 201",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421733",
            "telephone_number": "208-922-3093",
            "fax_number": "208-922-9351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 PARK AVE",
            "address_2": "208-752-8221",
            "city": "MULLAN",
            "state": "ID",
            "postal_code": "838460071",
            "telephone_number": "208-783-2870",
            "fax_number": "208-752-8221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MULLAN SCHOOL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEVESQUE",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "KENNETH",
        "authorized_official_title_or_position": "SYSTEMS MANAGER",
        "authorized_official_telephone_number": "208-922-3093",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Robert Bergstrom, MSW LCSW MPA
• Tammy Lynne Glidewell, RN

• Local Education Agency (LEA) in Mullan, ID
• Providers in Mullan, ID by specialty
• Local Education Agency (LEA) in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.