Provider Demographics
NPI:1578617171
Name:FORT SMITH SCHOOL DISTRICT 100
Entity Type:Organization
Organization Name:FORT SMITH SCHOOL DISTRICT 100
Other - Org Name:FT. SMITH PUBLIC SCHOOLS
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR, SPECIAL EDUCATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEVIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOCKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-785-2501
Mailing Address - Street 1:3205 JENNY LIND RD
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72901-7101
Mailing Address - Country:US
Mailing Address - Phone:479-785-2501
Mailing Address - Fax:479-709-6092
Practice Address - Street 1:3205 JENNY LIND RD
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72901-7101
Practice Address - Country:US
Practice Address - Phone:479-785-2501
Practice Address - Fax:479-709-6092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR121853761Medicaid
AR116050743Medicaid
AR158216791Medicaid