Healthcare Provider Details

I. General information

NPI: 1417050758
Provider Name (Legal Business Name): HALIFAX COUNTY PUBLIC SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 MARY BETHUNE ST
HALIFAX VA
24558-3213
US

IV. Provider business mailing address

1030 MARY BETHUNE STREET
HALIFAX VA
24558
US

V. Phone/Fax

Practice location:
  • Phone: 434-476-2171
  • Fax:
Mailing address:
  • Phone: 434-476-2171
  • 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: MR. LEON NELSON JOHNSON
Title or Position: DIRECTOR OF PUPIL PERSONNEL SERVICE
Credential:
Phone: 434-476-3103