Provider Demographics
NPI:1255500948
Name:RICHFIELD SCHOOL DIST 316
Entity Type:Organization
Organization Name:RICHFIELD SCHOOL DIST 316
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUISNESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-487-2241
Mailing Address - Street 1:555 N. TIGER DR.
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:ID
Mailing Address - Zip Code:83349
Mailing Address - Country:US
Mailing Address - Phone:208-487-2241
Mailing Address - Fax:208-487-2240
Practice Address - Street 1:555 N. TIGER DRIVE
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:ID
Practice Address - Zip Code:83349
Practice Address - Country:US
Practice Address - Phone:208-487-2241
Practice Address - Fax:208-487-2240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID0028556Medicaid