Provider Demographics
NPI:1427602432
Name:EAST WACO INNOVATIVE SCHOOL DEVELOPMENT
Entity Type:Organization
Organization Name:EAST WACO INNOVATIVE SCHOOL DEVELOPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARMEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-754-8000
Mailing Address - Street 1:1020 ELM ST STE 100
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76704-2277
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1020 ELM ST STE 100
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76704-2277
Practice Address - Country:US
Practice Address - Phone:254-754-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-29
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)