Provider Demographics
NPI:1972284065
Name:VAN-FAR R1 SCHOOLS
Entity Type:Organization
Organization Name:VAN-FAR R1 SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:FORTNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-594-6111
Mailing Address - Street 1:2200 W HWY 54
Mailing Address - Street 2:
Mailing Address - City:VANDALIA
Mailing Address - State:MO
Mailing Address - Zip Code:63382
Mailing Address - Country:US
Mailing Address - Phone:573-594-6111
Mailing Address - Fax:
Practice Address - Street 1:2200 W HWY 54
Practice Address - Street 2:
Practice Address - City:VANDALIA
Practice Address - State:MO
Practice Address - Zip Code:63382
Practice Address - Country:US
Practice Address - Phone:573-594-6111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health