Provider Demographics
NPI:1639402670
Name:FORT LEAVENWORTH USD 207
Entity Type:Organization
Organization Name:FORT LEAVENWORTH USD 207
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:BAEUCHLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-651-7373
Mailing Address - Street 1:207 EDUCATION WAY
Mailing Address - Street 2:
Mailing Address - City:FORT LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66027-1425
Mailing Address - Country:US
Mailing Address - Phone:913-651-7373
Mailing Address - Fax:913-758-6010
Practice Address - Street 1:207 EDUCATION WAY
Practice Address - Street 2:
Practice Address - City:FORT LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66027-1425
Practice Address - Country:US
Practice Address - Phone:913-651-7373
Practice Address - Fax:913-758-6010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-09
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health