Provider Demographics
NPI:1043340466
Name:EAST ST LOUIS DIST 189
Entity Type:Organization
Organization Name:EAST ST LOUIS DIST 189
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-646-3161
Mailing Address - Street 1:1005 STATE ST
Mailing Address - Street 2:
Mailing Address - City:EAST SAINT LOUIS
Mailing Address - State:IL
Mailing Address - Zip Code:62201-1907
Mailing Address - Country:US
Mailing Address - Phone:618-646-3161
Mailing Address - Fax:618-583-8361
Practice Address - Street 1:1005 STATE ST
Practice Address - Street 2:
Practice Address - City:EAST SAINT LOUIS
Practice Address - State:IL
Practice Address - Zip Code:62201-1907
Practice Address - Country:US
Practice Address - Phone:618-646-3161
Practice Address - Fax:618-583-8361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)