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General NPI Number Information
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NPI Number | 1114077310
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Entity Type | Organization
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Legal Business Name | SUPERINTENDENT OF BOONEVILLE HIGH SCHOOL
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 04/07/2020
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Provider Practice Location Address
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Address Line | 381 W 7TH ST
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City | BOONEVILLE
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State | AR
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Zip | 72927-3101
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Country | US
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Telephone | 479-675-3504
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Fax | 479-675-3186
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Provider Business Mailing Address
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Address Line | 381 W 7TH ST
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City | BOONEVILLE
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State | AR
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Zip | 72927-3101
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Country | US
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Telephone | 479-675-3504
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Fax | 479-675-3186
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Authorized Official
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Title or Position | LEA SUPERVISOR
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Name | MRS. MELISSA HANEY
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Credential |
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Telephone | 479-438-0427
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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