Provider Demographics
NPI:1447892336
Name:IMBODEN AREA CHARTER SCHOOL
Entity type:Organization
Organization Name:IMBODEN AREA CHARTER SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-869-3015
Mailing Address - Street 1:PO BOX 297
Mailing Address - Street 2:
Mailing Address - City:IMBODEN
Mailing Address - State:AR
Mailing Address - Zip Code:72434-0297
Mailing Address - Country:US
Mailing Address - Phone:870-869-3015
Mailing Address - Fax:
Practice Address - Street 1:605 W 3RD STREET
Practice Address - Street 2:
Practice Address - City:IMBODEN
Practice Address - State:AR
Practice Address - Zip Code:72434-0297
Practice Address - Country:US
Practice Address - Phone:870-869-3015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-11
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)