Provider Demographics
NPI:1497807135
Name:HOLLY SCHOOL DISTRICT RE-3
Entity Type:Organization
Organization Name:HOLLY SCHOOL DISTRICT RE-3
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:YOKUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-537-6616
Mailing Address - Street 1:PO BOX 608
Mailing Address - Street 2:3RD AND BUFFALO
Mailing Address - City:HOLLY
Mailing Address - State:CO
Mailing Address - Zip Code:81047-0608
Mailing Address - Country:US
Mailing Address - Phone:719-537-6616
Mailing Address - Fax:719-537-0315
Practice Address - Street 1:3RD AND BUFFALO
Practice Address - Street 2:
Practice Address - City:HOLLY
Practice Address - State:CO
Practice Address - Zip Code:81047-0608
Practice Address - Country:US
Practice Address - Phone:719-537-6616
Practice Address - Fax:719-537-0315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)