Provider Demographics
NPI:1639724529
Name:STREAM CHARTER SCHOOL
Entity Type:Organization
Organization Name:STREAM CHARTER SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL ED. DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JACKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RICO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-534-1633
Mailing Address - Street 1:455 ORO DAM BLVD E STE E
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95965-5733
Mailing Address - Country:US
Mailing Address - Phone:530-534-1633
Mailing Address - Fax:
Practice Address - Street 1:455 ORO DAM BLVD E STE E
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95965-5733
Practice Address - Country:US
Practice Address - Phone:530-534-1633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-07
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)