Provider Demographics
NPI:1124239967
Name:GALVESTON INDEPENDENT SCHOOL DISTRICT
Entity type:Organization
Organization Name:GALVESTON INDEPENDENT SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT OF SCHOOLS
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:CLEVELAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-766-5121
Mailing Address - Street 1:PO BOX 660
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77553-0660
Mailing Address - Country:US
Mailing Address - Phone:409-766-5100
Mailing Address - Fax:409-766-5106
Practice Address - Street 1:4115 AVENUE O
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77550-6940
Practice Address - Country:US
Practice Address - Phone:409-766-5858
Practice Address - Fax:409-762-7906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX065685203Medicaid
TX65685201Medicaid