Provider Demographics
NPI:1245699016
Name:SCHOOL SPECIFIED
Entity type:Organization
Organization Name:SCHOOL SPECIFIED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-497-9163
Mailing Address - Street 1:1 HOSPITAL ROAD
Mailing Address - Street 2:CALLER BOX C-268
Mailing Address - City:CHEROKEE
Mailing Address - State:NC
Mailing Address - Zip Code:28719-9253
Mailing Address - Country:US
Mailing Address - Phone:828-497-9163
Mailing Address - Fax:828-497-1723
Practice Address - Street 1:375 SEQUOYAH TRL
Practice Address - Street 2:
Practice Address - City:CHEROKEE
Practice Address - State:NC
Practice Address - Zip Code:28719
Practice Address - Country:US
Practice Address - Phone:828-497-9163
Practice Address - Fax:828-497-6977
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHEROKEE INDIAN HOSPITAL AUTHORITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-02-22
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0767COtherBCBSNC
NC3400156Medicaid
NC340156Medicare PIN
NC0767COtherBCBSNC