Provider Demographics
NPI:1902973100
Name:SUPERINTENDENT OF CLINTON SCHOOL
Entity Type:Organization
Organization Name:SUPERINTENDENT OF CLINTON SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:SWINK
Authorized Official - Suffix:
Authorized Official - Credentials:MSE
Authorized Official - Phone:501-745-6058
Mailing Address - Street 1:851 YELLOWJACKET LANE
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:AR
Mailing Address - Zip Code:72031
Mailing Address - Country:US
Mailing Address - Phone:501-745-6034
Mailing Address - Fax:501-745-6611
Practice Address - Street 1:851 YELLOWJACKET LANE
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:AR
Practice Address - Zip Code:72031
Practice Address - Country:US
Practice Address - Phone:501-745-6034
Practice Address - Fax:501-745-6611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR126364761Medicaid
AR149841791Medicaid
AR124452742Medicaid
AR125560743Medicaid