Healthcare Provider Details

I. General information

NPI: 1982938734
Provider Name (Legal Business Name): USD 285 CEDAR VALE SCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2009
Last Update Date: 09/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 DORA STREET
CEDAR VALE KS
67024-0458
US

IV. Provider business mailing address

PO BOX 458
CEDAR VALE KS
67024-0458
US

V. Phone/Fax

Practice location:
  • Phone: 620-758-2265
  • Fax: 620-758-2647
Mailing address:
  • Phone: 620-758-2265
  • Fax: 620-758-2647

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: MR. KENNETH C TARRANT SR.
Title or Position: SUPERINTENDENT
Credential:
Phone: 620-758-2265