Provider Demographics
NPI:1558556902
Name:LOCHLAND SCHOOL, INC.
Entity Type:Organization
Organization Name:LOCHLAND SCHOOL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DOMINIC
Authorized Official - Middle Name:R
Authorized Official - Last Name:CHRISTOPHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-789-5208
Mailing Address - Street 1:1065 LOCHLAND RD
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:NY
Mailing Address - Zip Code:14456-3244
Mailing Address - Country:US
Mailing Address - Phone:315-789-5208
Mailing Address - Fax:315-789-4597
Practice Address - Street 1:1065 LOCHLAND RD
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:NY
Practice Address - Zip Code:14456-3244
Practice Address - Country:US
Practice Address - Phone:315-789-5208
Practice Address - Fax:315-789-4597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02248328Medicaid
NY02700058Medicaid