Provider Demographics
NPI:1427144096
Name:PALESTINE CUSD 3
Entity type:Organization
Organization Name:PALESTINE CUSD 3
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HASTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-586-2713
Mailing Address - Street 1:100 S MAIN
Mailing Address - Street 2:
Mailing Address - City:PALESTINE
Mailing Address - State:IL
Mailing Address - Zip Code:62451
Mailing Address - Country:US
Mailing Address - Phone:618-586-2713
Mailing Address - Fax:
Practice Address - Street 1:100 S MAIN
Practice Address - Street 2:
Practice Address - City:PALESTINE
Practice Address - State:IL
Practice Address - Zip Code:62451
Practice Address - Country:US
Practice Address - Phone:618-586-2713
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid