Provider Demographics
NPI:1043477789
Name:ANCHORAGE IND. SCHOOLS
Entity type:Organization
Organization Name:ANCHORAGE IND. SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DON
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAVENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-245-8927
Mailing Address - Street 1:11400 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-2444
Mailing Address - Country:US
Mailing Address - Phone:502-245-8927
Mailing Address - Fax:502-245-2124
Practice Address - Street 1:11400 RIDGE RD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:KY
Practice Address - Zip Code:40223-2444
Practice Address - Country:US
Practice Address - Phone:502-245-8927
Practice Address - Fax:502-245-2124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-20
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY=========Medicaid