Provider Demographics
NPI:1043372642
Name:ADRIAN SCHOOL DISTRICT # 61
Entity Type:Organization
Organization Name:ADRIAN SCHOOL DISTRICT # 61
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GENE
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-372-2335
Mailing Address - Street 1:PO BOX 108
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:OR
Mailing Address - Zip Code:97901-0108
Mailing Address - Country:US
Mailing Address - Phone:541-372-2335
Mailing Address - Fax:
Practice Address - Street 1:202 HIGH STREET
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:OR
Practice Address - Zip Code:97901
Practice Address - Country:US
Practice Address - Phone:541-372-2335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR135959Medicaid