Provider Demographics
NPI:1316118904
Name:PARKSTON SCHOOL DISTRICT
Entity type:Organization
Organization Name:PARKSTON SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL SERVICES LEA
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-995-3021
Mailing Address - Street 1:102 C S CHAPMAN DR
Mailing Address - Street 2:
Mailing Address - City:PARKSTON
Mailing Address - State:SD
Mailing Address - Zip Code:57366-2017
Mailing Address - Country:US
Mailing Address - Phone:605-928-3368
Mailing Address - Fax:605-928-7284
Practice Address - Street 1:102 C S CHAPMAN DR
Practice Address - Street 2:
Practice Address - City:PARKSTON
Practice Address - State:SD
Practice Address - Zip Code:57366-2017
Practice Address - Country:US
Practice Address - Phone:605-928-3368
Practice Address - Fax:605-928-7284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-21
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5152190Medicare PIN