Healthcare Provider Details

I. General information

NPI: 1841352291
Provider Name (Legal Business Name): SHIRLEY SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 SCHOOL DR
SHIRLEY AR
72153-7524
US

IV. Provider business mailing address

154 SCHOOL DR
SHIRLEY AR
72153-7524
US

V. Phone/Fax

Practice location:
  • Phone: 501-745-6034
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: JACK ROBINSON
Title or Position: SUPERINTENDENT
Credential:
Phone: 501-745-6034