Provider Demographics
NPI:1144511635
Name:TWO RIVERS SCHOOL DISTRICT H
Entity type:Organization
Organization Name:TWO RIVERS SCHOOL DISTRICT H
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-272-3113
Mailing Address - Street 1:17727 E STATE HIGHWAY 28
Mailing Address - Street 2:
Mailing Address - City:OLA
Mailing Address - State:AR
Mailing Address - Zip Code:72853-9382
Mailing Address - Country:US
Mailing Address - Phone:479-272-3113
Mailing Address - Fax:479-272-3115
Practice Address - Street 1:17727 E STATE HIGHWAY 28
Practice Address - Street 2:
Practice Address - City:OLA
Practice Address - State:AR
Practice Address - Zip Code:72853-9382
Practice Address - Country:US
Practice Address - Phone:479-272-3113
Practice Address - Fax:479-272-3115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-02
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYR41981314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR184041761Medicaid