Provider Demographics
NPI:1518247766
Name:SOUTH CENTRAL COMMUNITY ACTION PROGRAM
Entity Type:Organization
Organization Name:SOUTH CENTRAL COMMUNITY ACTION PROGRAM
Other - Org Name:HEAD START
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEAD START DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:S
Authorized Official - Last Name:STUMPNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-334-8350
Mailing Address - Street 1:1502 W 15TH ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47404-3018
Mailing Address - Country:US
Mailing Address - Phone:812-334-8350
Mailing Address - Fax:812-335-3637
Practice Address - Street 1:1502 W 15TH ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47404-3018
Practice Address - Country:US
Practice Address - Phone:812-334-8350
Practice Address - Fax:812-335-3637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-19
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare