Provider Demographics
NPI:1053564245
Name:JACKSON R-2 SCHOOLS
Entity type:Organization
Organization Name:JACKSON R-2 SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECT SERVICES COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:OPAL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHANKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-243-9599
Mailing Address - Street 1:614 E ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MO
Mailing Address - Zip Code:63755-2150
Mailing Address - Country:US
Mailing Address - Phone:573-243-9501
Mailing Address - Fax:
Practice Address - Street 1:614 E ADAMS ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MO
Practice Address - Zip Code:63755-2150
Practice Address - Country:US
Practice Address - Phone:573-243-9501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-31
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)