Provider Demographics
NPI:1073653838
Name:COUNTY OF GASCONADE SCHOOL DISTRICT 2
Entity Type:Organization
Organization Name:COUNTY OF GASCONADE SCHOOL DISTRICT 2
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:KREMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-437-5401
Mailing Address - Street 1:PO BOX 536
Mailing Address - Street 2:
Mailing Address - City:OWENSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65066-0536
Mailing Address - Country:US
Mailing Address - Phone:573-437-5401
Mailing Address - Fax:573-437-5405
Practice Address - Street 1:3340 HIGHWAY 19
Practice Address - Street 2:
Practice Address - City:OWENSVILLE
Practice Address - State:MO
Practice Address - Zip Code:65066-2433
Practice Address - Country:US
Practice Address - Phone:573-437-5401
Practice Address - Fax:573-437-5405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251300000XAgenciesLocal Education Agency (LEA)
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO506076306Medicaid