Provider Demographics
NPI:1740353671
Name:NORTH CALLAWAY R-1 SCHOOL DISTRICT
Entity type:Organization
Organization Name:NORTH CALLAWAY R-1 SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL SERVICES DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUMGARTNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-386-2214
Mailing Address - Street 1:2690 THUNDERBIRD DRIVE
Mailing Address - Street 2:
Mailing Address - City:KINGDOM CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65262-1816
Mailing Address - Country:US
Mailing Address - Phone:573-386-2214
Mailing Address - Fax:573-386-2169
Practice Address - Street 1:2690 US HIGHWAY 54
Practice Address - Street 2:
Practice Address - City:KINGDOM CITY
Practice Address - State:MO
Practice Address - Zip Code:65262-0033
Practice Address - Country:US
Practice Address - Phone:573-386-2214
Practice Address - Fax:573-386-2169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO506112309Medicaid