Provider Demographics
NPI:1336644681
Name:SOUTHERN CASCADES COMMUNITY SERVICES DISTRICT
Entity Type:Organization
Organization Name:SOUTHERN CASCADES COMMUNITY SERVICES DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISTRICT MANAGGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:BOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-299-3110
Mailing Address - Street 1:PO BOX 239
Mailing Address - Street 2:
Mailing Address - City:ADIN
Mailing Address - State:CA
Mailing Address - Zip Code:96006-0239
Mailing Address - Country:US
Mailing Address - Phone:530-299-3110
Mailing Address - Fax:
Practice Address - Street 1:205 ASH VALLEY RD.
Practice Address - Street 2:
Practice Address - City:ADIN
Practice Address - State:CA
Practice Address - Zip Code:96006-0239
Practice Address - Country:US
Practice Address - Phone:530-299-3110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-28
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No3416L0300XTransportation ServicesAmbulanceLand Transport