Provider Demographics
NPI:1962531319
Name:COUNTY OF WELD SCHOOL DISTRICT RE 3
Entity type:Organization
Organization Name:COUNTY OF WELD SCHOOL DISTRICT RE 3
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXEC ADMIN ASST TO SPECIAL PROGRAMS
Authorized Official - Prefix:
Authorized Official - First Name:KEELEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ESSIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-536-2020
Mailing Address - Street 1:PO BOX 1022
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:CO
Mailing Address - Zip Code:80642-1022
Mailing Address - Country:US
Mailing Address - Phone:303-536-2000
Mailing Address - Fax:
Practice Address - Street 1:1101 4TH AVE
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:CO
Practice Address - Zip Code:80642-5074
Practice Address - Country:US
Practice Address - Phone:303-536-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-03
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO61489719Medicaid