Provider Demographics
NPI:1245438852
Name:WHITE HALL SCHOOL DISTRICT
Entity type:Organization
Organization Name:WHITE HALL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:J
Authorized Official - Last Name:LACY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-247-3698
Mailing Address - Street 1:1020 WEST HOLLAND
Mailing Address - Street 2:
Mailing Address - City:WHITE HALL
Mailing Address - State:AR
Mailing Address - Zip Code:71602
Mailing Address - Country:US
Mailing Address - Phone:870-247-3698
Mailing Address - Fax:870-247-3707
Practice Address - Street 1:1020 WEST HOLLAND
Practice Address - Street 2:
Practice Address - City:WHITE HALL
Practice Address - State:AR
Practice Address - Zip Code:71602
Practice Address - Country:US
Practice Address - Phone:870-247-3698
Practice Address - Fax:870-247-3707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-05
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR139049743Medicaid