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General NPI Number Information
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NPI Number | 1417073354
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Entity Type | Organization
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Legal Business Name | JOHNSON COUNTY SSA
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 300 E. CAPPS ST.
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City | RIO VISTA
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State | TX
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Zip | 76093
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Country | US
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Telephone | 817-373-3250
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 399
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City | RIO VISTA
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State | TX
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Zip | 76093-0399
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MS. CHERYL LAWS
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Credential |
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Telephone | 817-373-3250
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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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