1528709920 NPI number — HIGH PLAINS COMMUNITY SCHOOLS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528709920 NPI number — HIGH PLAINS COMMUNITY SCHOOLS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HIGH PLAINS COMMUNITY SCHOOLS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528709920
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/07/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
260 S PINE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
POLK
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68654-4065
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-765-2271
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
260 S PINE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
POLK
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68654-4065
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-765-2271
Provider Business Practice Location Address Fax Number:
402-765-7120
Provider Enumeration Date:
04/07/2022

Additional Information

Authorized Official

Authorized Official Last Name:
MATTOX
Authorized Official First Name:
JENNA
Authorized Official Middle Name:
Authorized Official Title or Position:
SPECIAL EDUCATION DIRECTOR
Authorized Official Telephone Number:
308-548-2216

Provider Taxonomy Codes

  • Taxonomy code: 251300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 72-0075 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".




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