Provider Demographics
NPI:1376612978
Name:MOUNTAIN GROVE R-III SCHOOL DISTRICT
Entity type:Organization
Organization Name:MOUNTAIN GROVE R-III SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL PROGRAMS DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RETA
Authorized Official - Middle Name:
Authorized Official - Last Name:TYRRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-926-3177
Mailing Address - Street 1:207 E 5TH ST
Mailing Address - Street 2:P.O. BOX 806
Mailing Address - City:MOUNTAIN GROVE
Mailing Address - State:MO
Mailing Address - Zip Code:65711-1660
Mailing Address - Country:US
Mailing Address - Phone:417-926-3177
Mailing Address - Fax:417-926-3177
Practice Address - Street 1:207 E 5TH ST
Practice Address - Street 2:
Practice Address - City:MOUNTAIN GROVE
Practice Address - State:MO
Practice Address - Zip Code:65711-1660
Practice Address - Country:US
Practice Address - Phone:417-926-3177
Practice Address - Fax:417-926-3177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)