Provider Demographics
NPI:1447463427
Name:SUPERINTENDENT OF GURDON HIGH SCHOOL
Entity type:Organization
Organization Name:SUPERINTENDENT OF GURDON HIGH SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:J
Authorized Official - Last Name:CROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-353-4454
Mailing Address - Street 1:314 SCHOOL STREET
Mailing Address - Street 2:
Mailing Address - City:GURDON,
Mailing Address - State:AR
Mailing Address - Zip Code:71743-0000
Mailing Address - Country:US
Mailing Address - Phone:870-353-4454
Mailing Address - Fax:870-353-4455
Practice Address - Street 1:314 SCHOOL STREET
Practice Address - Street 2:
Practice Address - City:GURDON,
Practice Address - State:AR
Practice Address - Zip Code:71743-0000
Practice Address - Country:US
Practice Address - Phone:870-353-4454
Practice Address - Fax:870-353-4455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty