Provider Demographics
NPI:1003899238
Name:LAURENS SCHOOL DISTRICT 55
Entity Type:Organization
Organization Name:LAURENS SCHOOL DISTRICT 55
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:WILBANKS
Authorized Official - Suffix:
Authorized Official - Credentials:SCHOOL DISTRICT
Authorized Official - Phone:864-984-8128
Mailing Address - Street 1:1029 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAURENS
Mailing Address - State:SC
Mailing Address - Zip Code:29360-2654
Mailing Address - Country:US
Mailing Address - Phone:864-984-8128
Mailing Address - Fax:864-984-8113
Practice Address - Street 1:1029 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LAURENS
Practice Address - State:SC
Practice Address - Zip Code:29360-2654
Practice Address - Country:US
Practice Address - Phone:864-984-8128
Practice Address - Fax:864-984-8113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services