Provider Demographics
NPI:1083807598
Name:DAHLONEGAH SCHOOL
Entity Type:Organization
Organization Name:DAHLONEGAH SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:LIMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-696-7807
Mailing Address - Street 1:RR 1 BOX 1795
Mailing Address - Street 2:
Mailing Address - City:STILWELL
Mailing Address - State:OK
Mailing Address - Zip Code:74960-9760
Mailing Address - Country:US
Mailing Address - Phone:918-696-7807
Mailing Address - Fax:918-696-2192
Practice Address - Street 1:RR 1 BOX 1795
Practice Address - Street 2:
Practice Address - City:STILWELL
Practice Address - State:OK
Practice Address - Zip Code:74960-9760
Practice Address - Country:US
Practice Address - Phone:918-696-7807
Practice Address - Fax:918-696-2192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty