Provider Demographics
NPI:1053335679
Name:PATON-CHURDAN CSD
Entity type:Organization
Organization Name:PATON-CHURDAN CSD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:EWING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-389-3111
Mailing Address - Street 1:606 ADRIAN ST
Mailing Address - Street 2:
Mailing Address - City:CHURDAN
Mailing Address - State:IA
Mailing Address - Zip Code:50050-7507
Mailing Address - Country:US
Mailing Address - Phone:515-389-3111
Mailing Address - Fax:
Practice Address - Street 1:606 ADRIAN ST
Practice Address - Street 2:
Practice Address - City:CHURDAN
Practice Address - State:IA
Practice Address - Zip Code:50050-7507
Practice Address - Country:US
Practice Address - Phone:515-389-3111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0454827Medicaid