Provider Demographics
NPI:1669949129
Name:BRADLEYVILLE R-I SCHOOL DISTRICT
Entity type:Organization
Organization Name:BRADLEYVILLE R-I SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LORRI
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-779-4166
Mailing Address - Street 1:PO BOX 20
Mailing Address - Street 2:
Mailing Address - City:BRADLEYVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65614-0020
Mailing Address - Country:US
Mailing Address - Phone:417-796-2288
Mailing Address - Fax:417-796-2289
Practice Address - Street 1:16474 N STATE HIGHWAY 125
Practice Address - Street 2:
Practice Address - City:BRADLEYVILLE
Practice Address - State:MO
Practice Address - Zip Code:65614-3869
Practice Address - Country:US
Practice Address - Phone:417-796-2288
Practice Address - Fax:417-796-2289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-01
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)