Provider Demographics
NPI:1417089657
Name:MANSFIELD PUBLIC SCHOOLS
Entity Type:Organization
Organization Name:MANSFIELD PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:HATTABAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-928-4006
Mailing Address - Street 1:402 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:AR
Mailing Address - Zip Code:72944-3422
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:402 GROVE ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:AR
Practice Address - Zip Code:72944-3422
Practice Address - Country:US
Practice Address - Phone:479-928-4006
Practice Address - Fax:479-928-4482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR128540721Medicaid
AR149608721Medicaid