Provider Demographics
NPI:1700094216
Name:CROSS COUNTY SCHOOL DISTRICT #7
Entity Type:Organization
Organization Name:CROSS COUNTY SCHOOL DISTRICT #7
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEA SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-442-2213
Mailing Address - Street 1:21 COUNTY ROAD 215
Mailing Address - Street 2:
Mailing Address - City:CHERRY VALLEY
Mailing Address - State:AR
Mailing Address - Zip Code:72324-8957
Mailing Address - Country:US
Mailing Address - Phone:870-442-2213
Mailing Address - Fax:870-588-3565
Practice Address - Street 1:21 COUNTY ROAD 215
Practice Address - Street 2:
Practice Address - City:CHERRY VALLEY
Practice Address - State:AR
Practice Address - Zip Code:72324-8957
Practice Address - Country:US
Practice Address - Phone:870-442-2213
Practice Address - Fax:870-588-3565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR117129743Medicaid
AR168175761Medicaid
AR182916732Medicaid