Provider Demographics
NPI:1134306749
Name:MOUNTAIN OAK CHARTER SCHOOL
Entity Type:Organization
Organization Name:MOUNTAIN OAK CHARTER SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPED DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:URQUHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-788-5227
Mailing Address - Street 1:124 N VIRGINIA ST
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-3224
Mailing Address - Country:US
Mailing Address - Phone:928-788-5227
Mailing Address - Fax:
Practice Address - Street 1:124 N VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-3224
Practice Address - Country:US
Practice Address - Phone:928-788-5227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management