Provider Demographics
NPI:1558539981
Name:STAATS EDUCATION SERVICES, LLC
Entity Type:Organization
Organization Name:STAATS EDUCATION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICKIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:STAATS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:812-521-6950
Mailing Address - Street 1:246 TAGGART DR
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:IN
Mailing Address - Zip Code:47274-3654
Mailing Address - Country:US
Mailing Address - Phone:812-521-6950
Mailing Address - Fax:812-523-2161
Practice Address - Street 1:246 TAGGART DR
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:IN
Practice Address - Zip Code:47274-3654
Practice Address - Country:US
Practice Address - Phone:812-521-6950
Practice Address - Fax:812-523-2161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INN/A251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health