Provider Demographics
NPI:1467590166
Name:BELLEVILLE SCHOOL DISTRICT 118
Entity Type:Organization
Organization Name:BELLEVILLE SCHOOL DISTRICT 118
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:618-234-4294
Mailing Address - Street 1:105 W A ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62220-1326
Mailing Address - Country:US
Mailing Address - Phone:618-234-4294
Mailing Address - Fax:618-233-4639
Practice Address - Street 1:105 W A ST
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62220-1326
Practice Address - Country:US
Practice Address - Phone:618-234-4294
Practice Address - Fax:618-233-4639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid