Provider Demographics
NPI:1871633248
Name:COUNTY OF BENTON SCHOOL DISTRICT R 2
Entity Type:Organization
Organization Name:COUNTY OF BENTON SCHOOL DISTRICT R 2
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL SERVICES DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:REESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-547-3514
Mailing Address - Street 1:PO BOX 39
Mailing Address - Street 2:101 W LAMINE
Mailing Address - City:LINCOLN
Mailing Address - State:MO
Mailing Address - Zip Code:65338-0039
Mailing Address - Country:US
Mailing Address - Phone:660-547-3514
Mailing Address - Fax:660-547-3401
Practice Address - Street 1:101 W LAMINE
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:MO
Practice Address - Zip Code:65338-0039
Practice Address - Country:US
Practice Address - Phone:660-547-3514
Practice Address - Fax:660-547-3401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2016-06-14
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
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO506258805Medicaid