=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215161708
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CLEVELAND COUNTY SCHOOL DISTRICT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/12/2009
-----------------------------------------------------
Last Update Date | 05/12/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 202 E PARKER STREET
-----------------------------------------------------
City | HAMBURG
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 71646
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 870-853-2864
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 700 MAIN STREET
-----------------------------------------------------
City | RISON
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 71665
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 870-853-2864
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SP ED
-----------------------------------------------------
Name | MRS. ANELL L MEEKS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 870-853-2864
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251300000X
-----------------------------------------------------
Taxonomy Name | Local Education Agency (LEA)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------