Provider Demographics
NPI:1457685240
Name:UNIFIED SCHOOL DISTRICT NO 264
Entity Type:Organization
Organization Name:UNIFIED SCHOOL DISTRICT NO 264
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-584-2091
Mailing Address - Street 1:150 S PROSPECT ST
Mailing Address - Street 2:PO BOX 248
Mailing Address - City:CLEARWATER
Mailing Address - State:KS
Mailing Address - Zip Code:67026-2601
Mailing Address - Country:US
Mailing Address - Phone:620-584-2091
Mailing Address - Fax:620-584-6705
Practice Address - Street 1:150 S PROSPECT ST
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:KS
Practice Address - Zip Code:67026-2601
Practice Address - Country:US
Practice Address - Phone:620-584-2091
Practice Address - Fax:620-584-6705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-25
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)