Provider Demographics
NPI:1144551946
Name:WINGS CHARTER MIDDLE SCHOOL, INC.
Entity type:Organization
Organization Name:WINGS CHARTER MIDDLE SCHOOL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LETHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLICK
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:208-734-2902
Mailing Address - Street 1:647 FILER AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-4008
Mailing Address - Country:US
Mailing Address - Phone:208-734-2902
Mailing Address - Fax:208-734-2907
Practice Address - Street 1:647 FILER AVE STE 100
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-4008
Practice Address - Country:US
Practice Address - Phone:208-734-2902
Practice Address - Fax:208-734-2907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-19
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)