Provider Demographics
NPI:1063553402
Name:ADVANCE R-IV PUBLIC SCHOOLS
Entity type:Organization
Organization Name:ADVANCE R-IV PUBLIC SCHOOLS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT OF SCHOOLS
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:REDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-722-3581
Mailing Address - Street 1:PO BOX 370
Mailing Address - Street 2:
Mailing Address - City:ADVANCE
Mailing Address - State:MO
Mailing Address - Zip Code:63730-0370
Mailing Address - Country:US
Mailing Address - Phone:573-722-3581
Mailing Address - Fax:573-722-9886
Practice Address - Street 1:19805 STATE HWY C
Practice Address - Street 2:
Practice Address - City:ADVANCE
Practice Address - State:MO
Practice Address - Zip Code:63730
Practice Address - Country:US
Practice Address - Phone:573-722-3581
Practice Address - Fax:573-722-9886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)