| Organization Name: | DESOTO CCSD 86 |
| NPI Number: | 1225200850 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK EDWARD BULLOCK (SUPERINTENDENT) |
| Mailing Address: | 311 Hurst Rd De Soto |
| State: | IL US |
| Postal Code: | 629241228 |
| Phone Number: | 6188672317 |
| Fax Number: | 6188673233 |
| NPI Enumeration Date: | 03/24/2008 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QS1000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Student Health |
| Taxonomy Definition: | |