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General NPI Number Information
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NPI Number | 1790962173
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Entity Type | Organization
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Legal Business Name | CYPRESS ELEM. SCHOOL DIST. #64
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Dates
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Enumeration Date | 01/28/2008
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Last Update Date | 01/28/2008
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Provider Practice Location Address
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Address Line | 4580 MOUNT PISGAH RD
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City | CYPRESS
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State | IL
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Zip | 62923-2139
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Country | US
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Telephone | 618-657-2525
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Fax | 618-657-2570
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Provider Business Mailing Address
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Address Line | PO BOX 109
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City | CYPRESS
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State | IL
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Zip | 62923-0109
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Country | US
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Telephone | 618-657-2525
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Fax | 618-657-2570
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Authorized Official
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Title or Position | SECRETARY/BOOKKEEPER
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Name | MRS. SHARON SUE OLIVER
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Credential |
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Telephone | 618-657-2525
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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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