Provider Demographics
NPI: | 1649490764 |
---|---|
Name: | ST. MARY PARISH SCHOOL BOARD |
Entity type: | Organization |
Organization Name: | ST. MARY PARISH SCHOOL BOARD |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | COORDINATOR OF RELATED SERVICES |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | STEPHEN |
Authorized Official - Middle Name: | J |
Authorized Official - Last Name: | HARRIS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MS-CCC-A |
Authorized Official - Phone: | 337-828-1767 |
Mailing Address - Street 1: | 402 IBERIA ST |
Mailing Address - Street 2: | P O DRAWER 580 |
Mailing Address - City: | FRANKLIN |
Mailing Address - State: | LA |
Mailing Address - Zip Code: | 70538-4916 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 337-828-1767 |
Mailing Address - Fax: | 337-828-5941 |
Practice Address - Street 1: | 402 IBERIA ST |
Practice Address - Street 2: | P O DRAWER 580 |
Practice Address - City: | FRANKLIN |
Practice Address - State: | LA |
Practice Address - Zip Code: | 70538-4916 |
Practice Address - Country: | US |
Practice Address - Phone: | 337-828-1767 |
Practice Address - Fax: | 337-828-5941 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-04-30 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 163WS0200X | Nursing Service Providers | Registered Nurse | School | Group - Single Specialty |