Provider Demographics
NPI:1477982684
Name:CARLE HIGH SCHOOL
Entity Type:Organization
Organization Name:CARLE HIGH SCHOOL
Other - Org Name:KONOCTI UNIFIED
Other - Org Type:Other Name
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:BURGER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:707-994-1033
Mailing Address - Street 1:PO BOX 309
Mailing Address - Street 2:
Mailing Address - City:LOWER LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:95457-0309
Mailing Address - Country:US
Mailing Address - Phone:707-994-1033
Mailing Address - Fax:
Practice Address - Street 1:9345 WINCHESTER STREET
Practice Address - Street 2:
Practice Address - City:LOWER LAKE
Practice Address - State:CA
Practice Address - Zip Code:95457-0309
Practice Address - Country:US
Practice Address - Phone:707-994-1033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)