Provider Demographics
NPI: | 1720358195 |
---|---|
Name: | DOUGLAS EDUCATION SERVICE DISTRICT |
Entity Type: | Organization |
Organization Name: | DOUGLAS EDUCATION SERVICE DISTRICT |
Other - Org Name: | DOUGLAS ESD |
Other - Org Type: | Other Name |
Authorized Official - Title/Position: | BUSINESS MANAGER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | BARB |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | TAYLOR |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 541-440-4752 |
Mailing Address - Street 1: | 1871 NE STEPHENS ST |
Mailing Address - Street 2: | |
Mailing Address - City: | ROSEBURG |
Mailing Address - State: | OR |
Mailing Address - Zip Code: | 97470-1433 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 541-440-4777 |
Mailing Address - Fax: | 541-440-4771 |
Practice Address - Street 1: | 1871 NE STEPHENS ST |
Practice Address - Street 2: | |
Practice Address - City: | ROSEBURG |
Practice Address - State: | OR |
Practice Address - Zip Code: | 97470-1433 |
Practice Address - Country: | US |
Practice Address - Phone: | 541-440-4777 |
Practice Address - Fax: | 541-440-4771 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2012-01-03 |
Last Update Date: | 2012-01-03 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251300000X | Agencies | Local Education Agency (LEA) | |
No | 252Y00000X | Agencies | Early Intervention Provider Agency |