Provider Demographics
NPI:1740433101
Name:NORTHERN HUMBOLDT UNION HIGH SCHOOL DISTRICT
Entity Type:Organization
Organization Name:NORTHERN HUMBOLDT UNION HIGH SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:STEPHENS
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:707-839-6470
Mailing Address - Street 1:2755 MCKINLEYVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:MCKINLEYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95519-3400
Mailing Address - Country:US
Mailing Address - Phone:707-839-6470
Mailing Address - Fax:707-839-6477
Practice Address - Street 1:2755 MCKINLEYVILLE AVE
Practice Address - Street 2:
Practice Address - City:MCKINLEYVILLE
Practice Address - State:CA
Practice Address - Zip Code:95519-3400
Practice Address - Country:US
Practice Address - Phone:707-839-6470
Practice Address - Fax:707-839-6477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASS1262687Medicaid