Provider Demographics
NPI:1588993943
Name:USD 500
Entity type:Organization
Organization Name:USD 500
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROJECT MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRETZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-627-5676
Mailing Address - Street 1:4601 STATE AVE
Mailing Address - Street 2:STE 38.SPED
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66102-3603
Mailing Address - Country:US
Mailing Address - Phone:913-627-5676
Mailing Address - Fax:913-627-5688
Practice Address - Street 1:4601 STATE AVE
Practice Address - Street 2:STE 38.SPED
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66102-3603
Practice Address - Country:US
Practice Address - Phone:913-627-5676
Practice Address - Fax:913-627-5688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-15
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100211550CMedicaid