Provider Demographics
NPI:1063560316
Name:SOUTH NODAWAY CO. R-IV SCHOOL DISTRICT
Entity type:Organization
Organization Name:SOUTH NODAWAY CO. R-IV SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRANCE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HUTCHINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-652-3221
Mailing Address - Street 1:209 MOREHOUSE ST
Mailing Address - Street 2:
Mailing Address - City:BARNARD
Mailing Address - State:MO
Mailing Address - Zip Code:64423-8201
Mailing Address - Country:US
Mailing Address - Phone:660-652-3727
Mailing Address - Fax:660-652-3411
Practice Address - Street 1:209 MOREHOUSE ST
Practice Address - Street 2:
Practice Address - City:BARNARD
Practice Address - State:MO
Practice Address - Zip Code:64423-8201
Practice Address - Country:US
Practice Address - Phone:660-652-3727
Practice Address - Fax:660-652-3411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO44-6006069251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO506245703Medicaid
MO463132720Medicaid