Provider Demographics
NPI:1093188278
Name:CABOOL R-IV
Entity Type:Organization
Organization Name:CABOOL R-IV
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JESTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-962-3153
Mailing Address - Street 1:1025 ROGERS AVE
Mailing Address - Street 2:
Mailing Address - City:CABOOL
Mailing Address - State:MO
Mailing Address - Zip Code:65689-7359
Mailing Address - Country:US
Mailing Address - Phone:417-962-3153
Mailing Address - Fax:417-962-5043
Practice Address - Street 1:1025 ROGERS AVE
Practice Address - Street 2:
Practice Address - City:CABOOL
Practice Address - State:MO
Practice Address - Zip Code:65689-7359
Practice Address - Country:US
Practice Address - Phone:417-962-3153
Practice Address - Fax:417-962-5043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-10
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)