Provider Demographics
NPI:1093994873
Name:MOUNTAIN HOME SCHOOL DISTRICT 193
Entity Type:Organization
Organization Name:MOUNTAIN HOME SCHOOL DISTRICT 193
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FISCAL OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:CLIFF
Authorized Official - Middle Name:
Authorized Official - Last Name:OGBORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-587-2588
Mailing Address - Street 1:470 N 3RD E
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:ID
Mailing Address - Zip Code:83647-2737
Mailing Address - Country:US
Mailing Address - Phone:208-587-2580
Mailing Address - Fax:208-587-9896
Practice Address - Street 1:470 N 3RD E
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:ID
Practice Address - Zip Code:83647-2737
Practice Address - Country:US
Practice Address - Phone:208-587-2580
Practice Address - Fax:208-587-9896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)