Provider Demographics
NPI:1568512812
Name:CALDWELL COUNTY BOARD OF EDUCATION
Entity Type:Organization
Organization Name:CALDWELL COUNTY BOARD OF EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL EDUCATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-365-8000
Mailing Address - Street 1:612 W WASHINGTON ST
Mailing Address - Street 2:P.O. BOX 229
Mailing Address - City:PRINCETON
Mailing Address - State:KY
Mailing Address - Zip Code:42445-1942
Mailing Address - Country:US
Mailing Address - Phone:270-365-8000
Mailing Address - Fax:270-365-5742
Practice Address - Street 1:612 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:KY
Practice Address - Zip Code:42445-1942
Practice Address - Country:US
Practice Address - Phone:270-365-8000
Practice Address - Fax:270-365-5742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY21000088251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY21000088Medicaid