Provider Demographics
NPI:1851524102
Name:USD 447 CHERRYVALE
Entity Type:Organization
Organization Name:USD 447 CHERRYVALE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:WAGONER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-336-8130
Mailing Address - Street 1:618 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:CHERRYVALE
Mailing Address - State:KS
Mailing Address - Zip Code:67335-2306
Mailing Address - Country:US
Mailing Address - Phone:620-336-8130
Mailing Address - Fax:
Practice Address - Street 1:618 E 4TH ST
Practice Address - Street 2:
Practice Address - City:CHERRYVALE
Practice Address - State:KS
Practice Address - Zip Code:67335-2306
Practice Address - Country:US
Practice Address - Phone:620-336-8130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRI COUNTY SPECIAL EDUCATION COOPERATIVE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-09-02
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)