Provider Demographics
NPI:1558496893
Name:NORTHRIDGE LOCAL SCHOOL DISTRICT
Entity Type:Organization
Organization Name:NORTHRIDGE LOCAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TOD
Authorized Official - Middle Name:M
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-278-5885
Mailing Address - Street 1:2011 TIMBER LN
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45414-4528
Mailing Address - Country:US
Mailing Address - Phone:937-278-5885
Mailing Address - Fax:937-276-8351
Practice Address - Street 1:2011 TIMBER LN
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45414-4528
Practice Address - Country:US
Practice Address - Phone:937-278-5885
Practice Address - Fax:937-276-8351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services