Provider Demographics
NPI:1689907214
Name:COUNTIES OF OSAGE & GASCONADE SCH R 1
Entity Type:Organization
Organization Name:COUNTIES OF OSAGE & GASCONADE SCH R 1
Other - Org Name:OSAGE COUNTY R-I
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NOWLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-763-5666
Mailing Address - Street 1:614 S POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:CHAMOIS
Mailing Address - State:MO
Mailing Address - Zip Code:65024-2649
Mailing Address - Country:US
Mailing Address - Phone:573-763-5666
Mailing Address - Fax:573-763-5686
Practice Address - Street 1:614 S POPLAR ST
Practice Address - Street 2:
Practice Address - City:CHAMOIS
Practice Address - State:MO
Practice Address - Zip Code:65024-2649
Practice Address - Country:US
Practice Address - Phone:573-763-5666
Practice Address - Fax:573-763-5686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-15
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251300000XAgenciesLocal Education Agency (LEA)
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty