Provider Demographics
NPI:1245387232
Name:MONTGOMERY COUNTY SCHOOLS
Entity Type:Organization
Organization Name:MONTGOMERY COUNTY SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, SPECIAL EDUCATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARDEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOODMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-497-8760
Mailing Address - Street 1:640 WOODFORD DRIVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353
Mailing Address - Country:US
Mailing Address - Phone:859-497-8760
Mailing Address - Fax:859-497-8780
Practice Address - Street 1:700 WOODFORD DR
Practice Address - Street 2:
Practice Address - City:MOUNT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353-9505
Practice Address - Country:US
Practice Address - Phone:859-497-8760
Practice Address - Fax:859-497-8780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY21087010251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY21087010Medicaid