Provider Demographics
NPI:1043366099
Name:WAUKEE COMMUNITY SCHOOL DISTRICT
Entity type:Organization
Organization Name:WAUKEE COMMUNITY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT OF SCHOOLS
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:WILKERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-987-5161
Mailing Address - Street 1:560 SE UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:WAUKEE
Mailing Address - State:IA
Mailing Address - Zip Code:50263-8171
Mailing Address - Country:US
Mailing Address - Phone:515-987-5161
Mailing Address - Fax:515-987-2701
Practice Address - Street 1:560 SE UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:WAUKEE
Practice Address - State:IA
Practice Address - Zip Code:50263-8171
Practice Address - Country:US
Practice Address - Phone:515-987-5161
Practice Address - Fax:515-987-2701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0463240Medicaid