Provider Demographics
NPI:1902231244
Name:FLORENCE ISD
Entity type:Organization
Organization Name:FLORENCE ISD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFRI
Authorized Official - Middle Name:
Authorized Official - Last Name:VAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-793-2850
Mailing Address - Street 1:PO BOX 489
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:TX
Mailing Address - Zip Code:76527-0489
Mailing Address - Country:US
Mailing Address - Phone:254-793-2850
Mailing Address - Fax:254-793-3055
Practice Address - Street 1:306 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:TX
Practice Address - Zip Code:76527-4062
Practice Address - Country:US
Practice Address - Phone:254-793-2850
Practice Address - Fax:254-793-3055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX144616301Medicaid