Provider Demographics
NPI:1417437765
Name:GREEN RIDGE R-VIII SCHOOL DISTRICT
Entity Type:Organization
Organization Name:GREEN RIDGE R-VIII SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAGEDORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-527-3315
Mailing Address - Street 1:401 W PETTIS ST
Mailing Address - Street 2:
Mailing Address - City:GREEN RIDGE
Mailing Address - State:MO
Mailing Address - Zip Code:65332-1160
Mailing Address - Country:US
Mailing Address - Phone:660-527-3315
Mailing Address - Fax:660-527-3299
Practice Address - Street 1:401 W PETTIS ST
Practice Address - Street 2:
Practice Address - City:GREEN RIDGE
Practice Address - State:MO
Practice Address - Zip Code:65332-1160
Practice Address - Country:US
Practice Address - Phone:660-527-3315
Practice Address - Fax:660-527-3299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)