Provider Demographics
NPI:1417073354
Name:JOHNSON COUNTY SSA
Entity Type:Organization
Organization Name:JOHNSON COUNTY SSA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-373-3250
Mailing Address - Street 1:PO BOX 399
Mailing Address - Street 2:
Mailing Address - City:RIO VISTA
Mailing Address - State:TX
Mailing Address - Zip Code:76093-0399
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 E. CAPPS ST.
Practice Address - Street 2:
Practice Address - City:RIO VISTA
Practice Address - State:TX
Practice Address - Zip Code:76093
Practice Address - Country:US
Practice Address - Phone:817-373-3250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)