Provider Demographics
NPI:1871328765
Name:LONE WOLF SCHOOL
Entity type:Organization
Organization Name:LONE WOLF SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:KENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACK
Authorized Official - Suffix:
Authorized Official - Credentials:M ED
Authorized Official - Phone:580-751-0145
Mailing Address - Street 1:1001 7TH ST
Mailing Address - Street 2:
Mailing Address - City:LONE WOLF
Mailing Address - State:OK
Mailing Address - Zip Code:73655-9781
Mailing Address - Country:US
Mailing Address - Phone:580-846-9091
Mailing Address - Fax:
Practice Address - Street 1:1001 7TH ST
Practice Address - Street 2:
Practice Address - City:LONE WOLF
Practice Address - State:OK
Practice Address - Zip Code:73655-9781
Practice Address - Country:US
Practice Address - Phone:580-846-9091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-03
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)