Provider Demographics
NPI:1902932361
Name:MAGOFFIN COUNTY BOARD OF EDUCATION
Entity Type:Organization
Organization Name:MAGOFFIN COUNTY BOARD OF EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLBROOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-349-6117
Mailing Address - Street 1:109 GARDNER TRAIL
Mailing Address - Street 2:
Mailing Address - City:SALYERSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41465
Mailing Address - Country:US
Mailing Address - Phone:606-349-6117
Mailing Address - Fax:606-349-6724
Practice Address - Street 1:109 GARDNER TRAIL
Practice Address - Street 2:
Practice Address - City:SALYERSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41465
Practice Address - Country:US
Practice Address - Phone:606-349-6117
Practice Address - Fax:606-349-6724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY21077011251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY21077011Medicaid