Healthcare Provider Details

I. General information

NPI: 1841522125
Provider Name (Legal Business Name): USD 379 CLAY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2010
Last Update Date: 02/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

807 DEXTER ST
CLAY CENTER KS
67432-2636
US

IV. Provider business mailing address

807 DEXTER ST
CLAY CENTER KS
67432-2636
US

V. Phone/Fax

Practice location:
  • Phone: 620-632-3176
  • 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: MICHAEL FOLKS
Title or Position: SUPERINTENDENT
Credential:
Phone: 785-632-3176