Provider Demographics
NPI:1730413964
Name:USD 204
Entity type:Organization
Organization Name:USD 204
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAMI
Authorized Official - Middle Name:
Authorized Official - Last Name:KOPPANGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-422-5600
Mailing Address - Street 1:2200 S 138TH ST
Mailing Address - Street 2:PO BOX 435
Mailing Address - City:BONNER SPRINGS
Mailing Address - State:KS
Mailing Address - Zip Code:66012-1631
Mailing Address - Country:US
Mailing Address - Phone:913-422-5600
Mailing Address - Fax:913-422-4193
Practice Address - Street 1:2200 S 138TH ST
Practice Address - Street 2:
Practice Address - City:BONNER SPRINGS
Practice Address - State:KS
Practice Address - Zip Code:66012-1631
Practice Address - Country:US
Practice Address - Phone:913-422-5600
Practice Address - Fax:913-422-9143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-21
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)