Provider Demographics
NPI:1659491579
Name:RIVERCREST I.S.D.
Entity Type:Organization
Organization Name:RIVERCREST I.S.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL EDUCATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:WAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-427-3891
Mailing Address - Street 1:1500 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75426-3420
Mailing Address - Country:US
Mailing Address - Phone:903-427-3891
Mailing Address - Fax:903-427-3578
Practice Address - Street 1:1500 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TX
Practice Address - Zip Code:75426-3420
Practice Address - Country:US
Practice Address - Phone:903-427-3891
Practice Address - Fax:903-427-3578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)