| Organization Name: | ST. MARIES SCHOOL DISTRICT #41 |
| NPI Number: | 1437378320 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHELLY GUIDRY (MEDICAID BILLING) |
| Mailing Address: | 720 Main Ave St Maries |
| State: | ID US |
| Postal Code: | 838611849 |
| Phone Number: | 2082452142 |
| Fax Number: | 2082455650 |
| NPI Enumeration Date: | 04/25/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235500000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Specialist/Technologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | General classification identifying individuals who are trained on a specific piece of equipment or technical procedure. |