Provider Demographics
NPI:1548607823
Name:BENTON COUNTY CHARTER SCHOOL ORGAN.
Entity Type:Organization
Organization Name:BENTON COUNTY CHARTER SCHOOL ORGAN.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-878-2787
Mailing Address - Street 1:8 HALSTED CIR
Mailing Address - Street 2:SUITE 5
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-3184
Mailing Address - Country:US
Mailing Address - Phone:479-878-2787
Mailing Address - Fax:479-878-2790
Practice Address - Street 1:8 HALSTED CIR
Practice Address - Street 2:SUITE 5
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-3184
Practice Address - Country:US
Practice Address - Phone:479-878-2787
Practice Address - Fax:479-878-2790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-28
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR194182720OtherAUDIOLOGY