Provider Demographics
NPI:1871610543
Name:SUPERINTENDENT OF HOXIE CONSOLIDATED SCHOOL DISTRICT
Entity type:Organization
Organization Name:SUPERINTENDENT OF HOXIE CONSOLIDATED SCHOOL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LEA SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:LATIMER
Authorized Official - Last Name:SEARS
Authorized Official - Suffix:
Authorized Official - Credentials:MCD, CCC-SLP
Authorized Official - Phone:870-886-4256
Mailing Address - Street 1:602 SW HARTIGAN ST
Mailing Address - Street 2:
Mailing Address - City:HOXIE
Mailing Address - State:AR
Mailing Address - Zip Code:72433-1811
Mailing Address - Country:US
Mailing Address - Phone:870-886-2401
Mailing Address - Fax:870-886-4252
Practice Address - Street 1:602 SW HARTIGAN ST
Practice Address - Street 2:
Practice Address - City:HOXIE
Practice Address - State:AR
Practice Address - Zip Code:72433-1811
Practice Address - Country:US
Practice Address - Phone:870-886-2401
Practice Address - Fax:870-886-4252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR143867792Medicaid