Provider Demographics
NPI:1679636054
Name:SOUTHEAST EDUCATION SERVICE COOP
Entity Type:Organization
Organization Name:SOUTHEAST EDUCATION SERVICE COOP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EARLY CHILDHOOD COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:870-367-6848
Mailing Address - Street 1:1022 SCOGIN DR
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:AR
Mailing Address - Zip Code:71655-9709
Mailing Address - Country:US
Mailing Address - Phone:870-367-6848
Mailing Address - Fax:870-367-9877
Practice Address - Street 1:1022 SCOGIN DR
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:AR
Practice Address - Zip Code:71655-9709
Practice Address - Country:US
Practice Address - Phone:870-367-6848
Practice Address - Fax:870-367-9877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2220251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)