Provider Demographics
NPI:1285912592
Name:ST. ELIZABETH R-IV SCHOOL
Entity type:Organization
Organization Name:ST. ELIZABETH R-IV SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-493-2246
Mailing Address - Street 1:PO BOX 68
Mailing Address - Street 2:240 CHURCH STREET
Mailing Address - City:SAINT ELIZABETH
Mailing Address - State:MO
Mailing Address - Zip Code:65075
Mailing Address - Country:US
Mailing Address - Phone:573-493-2246
Mailing Address - Fax:
Practice Address - Street 1:240 CHURCH STREET
Practice Address - Street 2:
Practice Address - City:SAINT ELIZABETH
Practice Address - State:MO
Practice Address - Zip Code:65075
Practice Address - Country:US
Practice Address - Phone:573-493-2246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-03
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)