Provider Demographics
NPI:1245421452
Name:CLOVERDALE COMMUNITY SCHOOL CORPORATION
Entity Type:Organization
Organization Name:CLOVERDALE COMMUNITY SCHOOL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MILNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-795-4664
Mailing Address - Street 1:310 E LOGAN ST
Mailing Address - Street 2:
Mailing Address - City:CLOVERDALE
Mailing Address - State:IN
Mailing Address - Zip Code:46120-8707
Mailing Address - Country:US
Mailing Address - Phone:765-795-4664
Mailing Address - Fax:765-795-5166
Practice Address - Street 1:310 E LOGAN ST
Practice Address - Street 2:
Practice Address - City:CLOVERDALE
Practice Address - State:IN
Practice Address - Zip Code:46120-8707
Practice Address - Country:US
Practice Address - Phone:765-795-4664
Practice Address - Fax:765-795-5166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN261QS1000X251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)