Provider Demographics
NPI:1730247388
Name:SUPT OF WONDERVIEW CONSOLIDATED SCHOOLS
Entity type:Organization
Organization Name:SUPT OF WONDERVIEW CONSOLIDATED SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:TYLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-354-0211
Mailing Address - Street 1:2436 HIGHWAY 95
Mailing Address - Street 2:
Mailing Address - City:HATTIEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72063-8929
Mailing Address - Country:US
Mailing Address - Phone:501-354-0211
Mailing Address - Fax:501-354-6071
Practice Address - Street 1:2436 HIGHWAY 95
Practice Address - Street 2:
Practice Address - City:HATTIEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72063-8929
Practice Address - Country:US
Practice Address - Phone:501-354-0211
Practice Address - Fax:501-354-6071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR148625742Medicaid