Provider Demographics
NPI:1912193467
Name:MAMMOTH SPRING SCHOOL DISTRICT
Entity Type:Organization
Organization Name:MAMMOTH SPRING SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT OF MAMMOTH SPRING SC
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LEN
Authorized Official - Last Name:TURNBOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-625-3612
Mailing Address - Street 1:PO BOX 370
Mailing Address - Street 2:
Mailing Address - City:MAMMOTH SPRING
Mailing Address - State:AR
Mailing Address - Zip Code:72554
Mailing Address - Country:US
Mailing Address - Phone:870-625-3612
Mailing Address - Fax:870-625-3609
Practice Address - Street 1:410 GOLDSMITH AVE.
Practice Address - Street 2:
Practice Address - City:MAMMOTH SPRING
Practice Address - State:AR
Practice Address - Zip Code:72554
Practice Address - Country:US
Practice Address - Phone:870-625-3612
Practice Address - Fax:870-625-3609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-19
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR119013743251300000X
AR158785721251300000X
AR155712721251300000X
AR131825721251300000X
251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)