Provider Demographics
NPI:1770777328
Name:KOKOMO SCHOOL CORPORATION
Entity type:Organization
Organization Name:KOKOMO SCHOOL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:HAUSWALD
Authorized Official - Suffix:
Authorized Official - Credentials:DR
Authorized Official - Phone:765-455-8000
Mailing Address - Street 1:PO BOX 2188
Mailing Address - Street 2:1500 S. WASHINGTON ST.
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46904-2188
Mailing Address - Country:US
Mailing Address - Phone:765-455-8000
Mailing Address - Fax:765-455-8018
Practice Address - Street 1:1500 S. WASHINGTON ST.
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46904-2188
Practice Address - Country:US
Practice Address - Phone:765-455-8000
Practice Address - Fax:765-455-8018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-28
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN100198480251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100198480Medicaid