Provider Demographics
NPI:1083730584
Name:LAKE RIDGE SCHOOLS
Entity Type:Organization
Organization Name:LAKE RIDGE SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HILDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAMIANICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-838-1819
Mailing Address - Street 1:6111 W RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GARY
Mailing Address - State:IN
Mailing Address - Zip Code:46408-1749
Mailing Address - Country:US
Mailing Address - Phone:219-838-1819
Mailing Address - Fax:219-989-7802
Practice Address - Street 1:6111 W RIDGE RD
Practice Address - Street 2:
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46408-1749
Practice Address - Country:US
Practice Address - Phone:219-838-1819
Practice Address - Fax:219-989-7802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)