Provider Demographics
NPI:1811226053
Name:JUNCTION CITY SCHOOL DISTRICT # 69
Entity Type:Organization
Organization Name:JUNCTION CITY SCHOOL DISTRICT # 69
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, SPECIAL PROGRAMS
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ADLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-998-6311
Mailing Address - Street 1:325 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:JUNCTION CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97448-1359
Mailing Address - Country:US
Mailing Address - Phone:541-998-6311
Mailing Address - Fax:541-998-3926
Practice Address - Street 1:325 MAPLE ST
Practice Address - Street 2:
Practice Address - City:JUNCTION CITY
Practice Address - State:OR
Practice Address - Zip Code:97448-1359
Practice Address - Country:US
Practice Address - Phone:541-998-6311
Practice Address - Fax:541-998-3926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-17
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR040183Medicaid