Provider Demographics
NPI:1730596065
Name:HOLLY CREEK SCHOOL
Entity type:Organization
Organization Name:HOLLY CREEK SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HARVEY
Authorized Official - Middle Name:D
Authorized Official - Last Name:BRUMLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-420-6968
Mailing Address - Street 1:401 HOLLY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:BROKEN BOW
Mailing Address - State:OK
Mailing Address - Zip Code:74728-5745
Mailing Address - Country:US
Mailing Address - Phone:580-420-6968
Mailing Address - Fax:580-420-7022
Practice Address - Street 1:401 HOLLY CREEK RD
Practice Address - Street 2:
Practice Address - City:BROKEN BOW
Practice Address - State:OK
Practice Address - Zip Code:74728-5745
Practice Address - Country:US
Practice Address - Phone:580-420-6968
Practice Address - Fax:580-420-7022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-18
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)