Provider Demographics
NPI:1518013994
Name:VALMEYER
Entity Type:Organization
Organization Name:VALMEYER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPT
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-935-2229
Mailing Address - Street 1:300 S CEDAR BLUFF DR
Mailing Address - Street 2:
Mailing Address - City:VALMEYER
Mailing Address - State:IL
Mailing Address - Zip Code:62295-3133
Mailing Address - Country:US
Mailing Address - Phone:618-935-2229
Mailing Address - Fax:
Practice Address - Street 1:300 S CEDAR BLUFF DR
Practice Address - Street 2:
Practice Address - City:VALMEYER
Practice Address - State:IL
Practice Address - Zip Code:62295-3133
Practice Address - Country:US
Practice Address - Phone:618-935-2229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
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