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General NPI Number Information
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NPI Number | 1255958575
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Entity Type | Organization
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Legal Business Name | CLAY COUNTY DISTRICT SCHOOLS
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Dates
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Enumeration Date | 07/02/2020
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Last Update Date | 07/02/2020
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Provider Practice Location Address
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Address Line | 23 SOUTH GREEN STREET
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City | GREEN COVE SPRINGS
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State | FL
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Zip | 32043-2705
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Country | US
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Telephone | 904-336-6871
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Fax | 904-336-6525
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Provider Business Mailing Address
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Address Line | 23 SOUTH GREEN STREET
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City | GREEN COVE SPRINGS
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State | FL
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Zip | 32043-2705
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Country | US
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Telephone | 904-336-6871
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Fax | 904-336-6525
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Authorized Official
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Title or Position | MEDICAID DATA ASSISTANT
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Name | MS. KATHY GRAY
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Credential |
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Telephone | 904-336-6871
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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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