Provider Demographics
NPI:1346460458
Name:EAST FELICIANA PARISH SCHOOL BOARD
Entity Type:Organization
Organization Name:EAST FELICIANA PARISH SCHOOL BOARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-683-8277
Mailing Address - Street 1:PO BOX 397
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:LA
Mailing Address - Zip Code:70722-0397
Mailing Address - Country:US
Mailing Address - Phone:225-683-8277
Mailing Address - Fax:
Practice Address - Street 1:12732 SILLIMAN STREET
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:LA
Practice Address - Zip Code:70722-0397
Practice Address - Country:US
Practice Address - Phone:225-683-8277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1415413Medicaid