Provider Demographics
NPI:1821262478
Name:SCHOOL DISTRICT R 1
Entity Type:Organization
Organization Name:SCHOOL DISTRICT R 1
Other - Org Name:WELLSVILLE MIDDLETOWN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF SPECIAL EDUCATION
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:GOSSEEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-684-2071
Mailing Address - Street 1:900 BURLINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WELLSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63384-1114
Mailing Address - Country:US
Mailing Address - Phone:573-684-2071
Mailing Address - Fax:573-684-2018
Practice Address - Street 1:900 BURLINGTON ST
Practice Address - Street 2:
Practice Address - City:WELLSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63384-1114
Practice Address - Country:US
Practice Address - Phone:573-684-2071
Practice Address - Fax:573-684-2018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-15
Last Update Date:2016-06-15
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