Provider Demographics
NPI:1982761714
Name:MENIFEE COUNTY BOARD OF EDUCATION
Entity type:Organization
Organization Name:MENIFEE COUNTY BOARD OF EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL EDUCATION
Authorized Official - Prefix:MS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARDEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-768-8002
Mailing Address - Street 1:P.O. BOX 110
Mailing Address - Street 2:202 BACK STREET
Mailing Address - City:FRENCHBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40322
Mailing Address - Country:US
Mailing Address - Phone:606-768-8002
Mailing Address - Fax:606-768-8050
Practice Address - Street 1:202 BACK STREET
Practice Address - Street 2:
Practice Address - City:FRENCHBURG
Practice Address - State:KY
Practice Address - Zip Code:40322-0110
Practice Address - Country:US
Practice Address - Phone:606-768-8002
Practice Address - Fax:606-768-8050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2009-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY282705054235Z00000X
KY401115322235Z00000X
251300000X
KYR0059251300000X
KYR1249251300000X
KY406987054251300000X
KY1408251300000X
KY5026251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251300000XAgenciesLocal Education Agency (LEA)Group - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY21000237Medicaid