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General NPI Number Information
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NPI Number | 1306038559
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Entity Type | Organization
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Legal Business Name | KANKAKEE VALLEY SCHOOL CORPORATION
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Dates
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Enumeration Date | 08/13/2007
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Last Update Date | 08/13/2007
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Provider Practice Location Address
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Address Line | 12021 NORTH 550 WEST
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City | WHEATFIELD
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State | IN
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Zip | 46392
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Country | US
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Telephone | 219-987-4711
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Fax |
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Provider Business Mailing Address
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Address Line | 12021 NORTH 550 WEST P. O. BOX 278
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City | WHEATFIELD
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State | IN
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Zip | 46392
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Country | US
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Telephone | 219-987-4711
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Fax |
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Authorized Official
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Title or Position | SUPERINTENDENT
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Name | MR. GLENN KRUEGER
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Credential |
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Telephone | 219-987-4711
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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 | IN
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