=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417087578
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SABINE PARISH SCHOOLS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/07/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 695 PETERSON ST
-----------------------------------------------------
City | MANY
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71449-2647
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-256-9228
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1079
-----------------------------------------------------
City | MANY
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71449-1079
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SUPERINTENDENT OF SCHOOLS
-----------------------------------------------------
Name | DORMAN JACKSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 318-256-9228
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251300000X
-----------------------------------------------------
Taxonomy Name | Local Education Agency (LEA)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------