Provider Demographics
NPI:1417041179
Name:NEWAYGO COUNTY RESA
Entity Type:Organization
Organization Name:NEWAYGO COUNTY RESA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL EDUCATION
Authorized Official - Prefix:MS
Authorized Official - First Name:EVA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUSEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-924-3834
Mailing Address - Street 1:4747 W. 48TH STREET
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:MI
Mailing Address - Zip Code:49412
Mailing Address - Country:US
Mailing Address - Phone:231-924-0381
Mailing Address - Fax:231-924-8817
Practice Address - Street 1:4747 W. 48TH STREET
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:MI
Practice Address - Zip Code:49412
Practice Address - Country:US
Practice Address - Phone:231-924-0381
Practice Address - Fax:231-924-8817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2966047Medicaid