Provider Demographics
NPI:1376785444
Name:COWDEN-HERRICK CUSD 3A
Entity Type:Organization
Organization Name:COWDEN-HERRICK CUSD 3A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT OF SCHOOLS
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:REGINALD
Authorized Official - Last Name:CADWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-783-2126
Mailing Address - Street 1:301 S GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:COWDEN
Mailing Address - State:IL
Mailing Address - Zip Code:62422-1105
Mailing Address - Country:US
Mailing Address - Phone:217-783-2126
Mailing Address - Fax:217-783-2126
Practice Address - Street 1:301 S GRAND AVE
Practice Address - Street 2:
Practice Address - City:COWDEN
Practice Address - State:IL
Practice Address - Zip Code:62422-1105
Practice Address - Country:US
Practice Address - Phone:217-783-2126
Practice Address - Fax:217-783-2126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-03
Last Update Date:2009-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management