Healthcare Provider Details

I. General information

NPI: 1417197146
Provider Name (Legal Business Name): CAREY EXEMPTED VILLAGE SCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2009
Last Update Date: 10/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2016 BLUE DEVIL DR
CAREY OH
43316-2016
US

IV. Provider business mailing address

2016 BLUE DEVIL DR
CAREY OH
43316-2016
US

V. Phone/Fax

Practice location:
  • Phone: 419-396-7922
  • Fax: 419-396-3158
Mailing address:
  • Phone: 419-396-7922
  • Fax: 419-396-3158

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: KAREN S PHILLIPS
Title or Position: TREASURER CFO
Credential:
Phone: 419-396-7922