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General NPI Number Information
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NPI Number | 1649502311
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Entity Type | Organization
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Legal Business Name | MANSFIELD R-IV
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Dates
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Enumeration Date | 02/05/2010
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Last Update Date | 02/05/2010
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Provider Practice Location Address
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Address Line | 316 WEST OHIO AVENUE
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City | MANSFIELD
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State | MO
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Zip | 65704-9301
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Country | US
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Telephone | 417-924-8458
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Fax | 417-924-3427
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Provider Business Mailing Address
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Address Line | 316 W OHIO AVENUE
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City | MANSFIELD
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State | MO
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Zip | 65704-9301
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Country | US
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Telephone | 417-924-8458
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Fax |
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Authorized Official
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Title or Position | SUPERINTENDENT OF SCHOOL
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Name | MR. RANDY SHORT
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Credential |
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Telephone | 417-924-8458
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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 | MO
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