Provider Demographics
NPI:1699830307
Name:BELLEVILLE HENDERSON CENTRAL SCHOOL
Entity Type:Organization
Organization Name:BELLEVILLE HENDERSON CENTRAL SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CSE CHAIRPERSON
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-846-5825
Mailing Address - Street 1:8372 RT 75
Mailing Address - Street 2:BOX 158
Mailing Address - City:BELLEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13611-0158
Mailing Address - Country:US
Mailing Address - Phone:315-846-5825
Mailing Address - Fax:315-846-5617
Practice Address - Street 1:8372 RT 75
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NY
Practice Address - Zip Code:13611-0158
Practice Address - Country:US
Practice Address - Phone:315-846-5825
Practice Address - Fax:315-846-5617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01381722Medicaid