Provider Demographics
NPI:1790907814
Name:MARIPOSA COUNTY OFFICE OF EDUCATION
Entity Type:Organization
Organization Name:MARIPOSA COUNTY OFFICE OF EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR SPECIAL EDUCATION/SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:DAMM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-742-0231
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:MARIPOSA
Mailing Address - State:CA
Mailing Address - Zip Code:95338-0008
Mailing Address - Country:US
Mailing Address - Phone:209-742-0231
Mailing Address - Fax:
Practice Address - Street 1:5082 OLD HIGHWAY NORTH
Practice Address - Street 2:
Practice Address - City:MARIPOSA
Practice Address - State:CA
Practice Address - Zip Code:95338
Practice Address - Country:US
Practice Address - Phone:209-742-0231
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASS2210223251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASS2210223Medicaid