Provider Demographics
NPI:1508593195
Name:SOUTHERN VALLEY SCHOOLS
Entity Type:Organization
Organization Name:SOUTHERN VALLEY SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:JORGENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-868-2222
Mailing Address - Street 1:43739 HIGHWAY 89
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:NE
Mailing Address - Zip Code:68967-2711
Mailing Address - Country:US
Mailing Address - Phone:308-868-2222
Mailing Address - Fax:
Practice Address - Street 1:43739 HIGHWAY 89
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:NE
Practice Address - Zip Code:68967-2711
Practice Address - Country:US
Practice Address - Phone:308-868-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health