Provider Demographics
NPI:1063681427
Name:ALLENDALE COMMUNITY CONSOLIDATED SCHOOL DISTRICT #17
Entity Type:Organization
Organization Name:ALLENDALE COMMUNITY CONSOLIDATED SCHOOL DISTRICT #17
Other - Org Name:ALLENDALE ELEMENTARY SCHOOL
Other - Org Type:Other Name
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:E
Authorized Official - Last Name:EMERY
Authorized Official - Suffix:
Authorized Official - Credentials:ED SPEC
Authorized Official - Phone:618-299-3161
Mailing Address - Street 1:101 N 3RD ST
Mailing Address - Street 2:PO BOX 130
Mailing Address - City:ALLENDALE
Mailing Address - State:IL
Mailing Address - Zip Code:62410-9569
Mailing Address - Country:US
Mailing Address - Phone:618-299-3161
Mailing Address - Fax:618-299-2015
Practice Address - Street 1:101 N 3RD ST
Practice Address - Street 2:
Practice Address - City:ALLENDALE
Practice Address - State:IL
Practice Address - Zip Code:62410-9569
Practice Address - Country:US
Practice Address - Phone:618-299-3161
Practice Address - Fax:618-299-2015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)