Provider Demographics
NPI:1619093481
Name:PORTAGE COUNTY EDUCATIONAL SERVICE CENTER
Entity Type:Organization
Organization Name:PORTAGE COUNTY EDUCATIONAL SERVICE CENTER
Other - Org Name:PORTAGE COUNTY BOARD OF EDUCATION
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DEWEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-297-1436
Mailing Address - Street 1:326 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-3136
Mailing Address - Country:US
Mailing Address - Phone:330-297-1436
Mailing Address - Fax:330-297-1113
Practice Address - Street 1:326 E MAIN ST
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-3136
Practice Address - Country:US
Practice Address - Phone:330-297-1436
Practice Address - Fax:330-297-1113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH049165251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH049163OtherSTATE IRN