Provider Demographics
NPI:1043358278
Name:NORTHEAST BOCES
Entity Type:Organization
Organization Name:NORTHEAST BOCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPED DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:DURBIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-774-6152
Mailing Address - Street 1:PO BOX 98
Mailing Address - Street 2:
Mailing Address - City:HAXTUN
Mailing Address - State:CO
Mailing Address - Zip Code:80731-0098
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:301 W POWELL ST
Practice Address - Street 2:
Practice Address - City:HAXTUN
Practice Address - State:CO
Practice Address - Zip Code:80731-2654
Practice Address - Country:US
Practice Address - Phone:970-774-6152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO47256222Medicaid