Provider Demographics
NPI:1205989746
Name:SPRINGDALE PUBLIC SCHOOLS
Entity type:Organization
Organization Name:SPRINGDALE PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION DIR.
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:BROOK
Authorized Official - Last Name:INGRAM
Authorized Official - Suffix:
Authorized Official - Credentials:M EDS
Authorized Official - Phone:479-750-8880
Mailing Address - Street 1:409 N THOMPSON ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72764
Mailing Address - Country:US
Mailing Address - Phone:479-750-8880
Mailing Address - Fax:844-952-0184
Practice Address - Street 1:409 N THOMPSON ST
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72764
Practice Address - Country:US
Practice Address - Phone:479-750-8880
Practice Address - Fax:844-952-0184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR120647751Medicaid
AR117595742Medicaid
AR117591743Medicaid