Provider Demographics
NPI:1922156587
Name:CAMPBELLSVILLE BOARD OF EDUCATION
Entity Type:Organization
Organization Name:CAMPBELLSVILLE BOARD OF EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODS-AYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-465-4162
Mailing Address - Street 1:136 S COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:CAMPBELLSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42718-1339
Mailing Address - Country:US
Mailing Address - Phone:270-465-4162
Mailing Address - Fax:270-465-3918
Practice Address - Street 1:136 S COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:CAMPBELLSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42718-1339
Practice Address - Country:US
Practice Address - Phone:270-465-4162
Practice Address - Fax:270-465-3918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
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
KY21000245Medicaid