Provider Demographics
NPI:1770625089
Name:BOWLING GREEN INDEPENDENT SCHOOLS
Entity type:Organization
Organization Name:BOWLING GREEN INDEPENDENT SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE SUPERINTENDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEILA
Authorized Official - Middle Name:V
Authorized Official - Last Name:WRITSEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-746-2200
Mailing Address - Street 1:1211 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-6801
Mailing Address - Country:US
Mailing Address - Phone:270-746-2200
Mailing Address - Fax:270-746-2205
Practice Address - Street 1:1211 CENTER ST
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-6801
Practice Address - Country:US
Practice Address - Phone:270-746-2200
Practice Address - Fax:270-746-2205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY21114020251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251300000XAgenciesLocal Education Agency (LEA)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY21114020Medicaid