Provider Demographics
NPI:1861820979
Name:LAKE COUNTY OFFICE OF EDUCATION
Entity Type:Organization
Organization Name:LAKE COUNTY OFFICE OF EDUCATION
Other - Org Name:CLEARLAKE CREATIVITY SCHOOL
Other - Org Type:Other Name
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:BROCK
Authorized Official - Middle Name:
Authorized Official - Last Name:FALKENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-262-4101
Mailing Address - Street 1:1152 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAKEPORT
Mailing Address - State:CA
Mailing Address - Zip Code:95453-5517
Mailing Address - Country:US
Mailing Address - Phone:707-995-9523
Mailing Address - Fax:707-995-9059
Practice Address - Street 1:6945 OLD HIGHWAY 53
Practice Address - Street 2:
Practice Address - City:CLEARLAKE
Practice Address - State:CA
Practice Address - Zip Code:95422
Practice Address - Country:US
Practice Address - Phone:707-995-9523
Practice Address - Fax:707-995-9059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)