Provider Demographics
NPI:1578708830
Name:SOUTHEASTERN LOCAL SCHOOL DISTRICT
Entity Type:Organization
Organization Name:SOUTHEASTERN LOCAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-462-8388
Mailing Address - Street 1:195 JAMESTOWN ST.
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:OH
Mailing Address - Zip Code:45368
Mailing Address - Country:US
Mailing Address - Phone:937-462-8388
Mailing Address - Fax:937-462-7915
Practice Address - Street 1:195 JAMESTOWN ST.
Practice Address - Street 2:
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:OH
Practice Address - Zip Code:45368
Practice Address - Country:US
Practice Address - Phone:937-462-8388
Practice Address - Fax:937-462-7915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-15
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0902232Medicaid