Provider Demographics
NPI:1053640672
Name:CLARK COUNTY BOARD OF EDUCATION
Entity Type:Organization
Organization Name:CLARK COUNTY BOARD OF EDUCATION
Other - Org Name:CLARK COUNTY SCHOOLS
Other - Org Type:Other Name
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-744-4545
Mailing Address - Street 1:1600 W LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40391-1145
Mailing Address - Country:US
Mailing Address - Phone:859-744-4545
Mailing Address - Fax:
Practice Address - Street 1:1600 W LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391-1145
Practice Address - Country:US
Practice Address - Phone:859-744-4545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-10
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY=========Medicaid