Provider Demographics
NPI:1215214994
Name:OPTIONS FOR OPPORTUNITY
Entity Type:Organization
Organization Name:OPTIONS FOR OPPORTUNITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INCORPORATOR/TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:MOYA
Authorized Official - Middle Name:J
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-935-4858
Mailing Address - Street 1:2706 BURNT VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:CHEWELAH
Mailing Address - State:WA
Mailing Address - Zip Code:99109-9615
Mailing Address - Country:US
Mailing Address - Phone:509-935-4858
Mailing Address - Fax:509-935-4854
Practice Address - Street 1:2706 BURNT VALLEY RD
Practice Address - Street 2:
Practice Address - City:CHEWELAH
Practice Address - State:WA
Practice Address - Zip Code:99109-9615
Practice Address - Country:US
Practice Address - Phone:509-935-4858
Practice Address - Fax:509-935-4854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-09
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602-900-917251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA602-900-917OtherUBI NUMBER