Provider Demographics
NPI:1538312137
Name:BELLE FOURCHE SCHOOL DISTRICT 9-1
Entity type:Organization
Organization Name:BELLE FOURCHE SCHOOL DISTRICT 9-1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:O'DEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-723-3355
Mailing Address - Street 1:2305 13TH AVE
Mailing Address - Street 2:
Mailing Address - City:BELLE FOURCHE
Mailing Address - State:SD
Mailing Address - Zip Code:57717-2404
Mailing Address - Country:US
Mailing Address - Phone:605-723-3355
Mailing Address - Fax:605-723-3366
Practice Address - Street 1:2305 13TH AVE
Practice Address - Street 2:
Practice Address - City:BELLE FOURCHE
Practice Address - State:SD
Practice Address - Zip Code:57717-2404
Practice Address - Country:US
Practice Address - Phone:605-723-3355
Practice Address - Fax:605-723-3366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5150510Medicaid