Provider Demographics
NPI:1063506772
Name:JASPER COUNTY COMM UNIT DIST 1
Entity Type:Organization
Organization Name:JASPER COUNTY COMM UNIT DIST 1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAVAGEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-783-8459
Mailing Address - Street 1:609 S LAFAYETTE
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:IL
Mailing Address - Zip Code:62448
Mailing Address - Country:US
Mailing Address - Phone:618-783-8459
Mailing Address - Fax:
Practice Address - Street 1:609 S LAFAYETTE
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:IL
Practice Address - Zip Code:62448
Practice Address - Country:US
Practice Address - Phone:618-783-8459
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid