Provider Demographics
NPI:1568484624
Name:CLAY AND WASHINGTON COUNTY
Entity Type:Organization
Organization Name:CLAY AND WASHINGTON COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ED
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-747-2604
Mailing Address - Street 1:PO BOX 189
Mailing Address - Street 2:
Mailing Address - City:GIRARD
Mailing Address - State:KS
Mailing Address - Zip Code:66743-0189
Mailing Address - Country:US
Mailing Address - Phone:888-654-8701
Mailing Address - Fax:620-724-7141
Practice Address - Street 1:412 PARK
Practice Address - Street 2:BOX 219
Practice Address - City:GREENLEAF
Practice Address - State:KS
Practice Address - Zip Code:66943
Practice Address - Country:US
Practice Address - Phone:785-747-2604
Practice Address - Fax:785-747-2424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100297910AMedicaid