Provider Demographics
NPI:1427103514
Name:UNION-NORTH UNITED SCHOOL CORPORATION
Entity type:Organization
Organization Name:UNION-NORTH UNITED SCHOOL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT OF SCHOOLS
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-784-8141
Mailing Address - Street 1:22601 TYLER RD
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46536-9733
Mailing Address - Country:US
Mailing Address - Phone:574-784-8141
Mailing Address - Fax:574-784-2181
Practice Address - Street 1:22601 TYLER RD
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:IN
Practice Address - Zip Code:46536-9733
Practice Address - Country:US
Practice Address - Phone:574-784-8141
Practice Address - Fax:574-784-2181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty