Provider Demographics
NPI:1740399617
Name:LEE COUNTY SCHOOL
Entity Type:Organization
Organization Name:LEE COUNTY SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:WIDENER, JR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-346-2107
Mailing Address - Street 1:5 PARK STREET
Mailing Address - Street 2:
Mailing Address - City:JONESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24263
Mailing Address - Country:US
Mailing Address - Phone:276-346-2107
Mailing Address - Fax:276-346-0307
Practice Address - Street 1:5 PARK STREET
Practice Address - Street 2:
Practice Address - City:JONESVILLE
Practice Address - State:VA
Practice Address - Zip Code:24263
Practice Address - Country:US
Practice Address - Phone:276-346-2107
Practice Address - Fax:276-346-0307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
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
VA4979338Medicaid