Healthcare Provider Details

I. General information

NPI: 1447453709
Provider Name (Legal Business Name): DEER MOUNT. JUDEA SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 06/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 OLD BELLEFONTE RD
HARRISON AR
72601-5542
US

IV. Provider business mailing address

525 OLD BELLEFONTE RD
HARRISON AR
72601-5542
US

V. Phone/Fax

Practice location:
  • Phone: 870-743-9100
  • Fax:
Mailing address:
  • Phone: 870-743-9100
  • Fax: 870-743-9100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: TRACY LYNN RINE
Title or Position: SPECIAL ED ADMINISTRATIVE SECRETARY
Credential:
Phone: 870-743-9100