Provider Demographics
NPI:1013038470
Name:SHELBY COUNTY SCHOOLS
Entity Type:Organization
Organization Name:SHELBY COUNTY SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPPORT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:CROUCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-647-0210
Mailing Address - Street 1:1155 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-1419
Mailing Address - Country:US
Mailing Address - Phone:502-647-0210
Mailing Address - Fax:502-633-1988
Practice Address - Street 1:1155 MAIN ST
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:KY
Practice Address - Zip Code:40065-1419
Practice Address - Country:US
Practice Address - Phone:502-647-0210
Practice Address - Fax:502-633-1988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY21106018Medicaid