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Organization

CENTRAL SCHOOL DISTRICT #104

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. STEVE AMIZICH (SUPERINTENDENT)
(618) 632-6336
Entity
Organization

Contact information

Practice address
309 HARTMAN LN, O FALLON, IL 62269-1725
(618) 632-6336
(618) 632-0870
Mailing address
309 HARTMAN LN, O FALLON, IL 62269-1725
(618) 632-6336
(618) 632-0870

Taxonomy

Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary

Other

Enumeration date
01/30/2007
Last updated
08/22/2020
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