Provider Demographics
NPI:1871633560
Name:GOODRICH ISD
Entity Type:Organization
Organization Name:GOODRICH ISD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST. SUPT FOR SPECIAL PROGRAMS
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:KELM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-628-3396
Mailing Address - Street 1:1401 S BYRD AVE
Mailing Address - Street 2:
Mailing Address - City:SHEPHERD
Mailing Address - State:TX
Mailing Address - Zip Code:77371-3582
Mailing Address - Country:US
Mailing Address - Phone:936-628-3396
Mailing Address - Fax:936-628-3841
Practice Address - Street 1:1401 S BYRD AVE
Practice Address - Street 2:
Practice Address - City:SHEPHERD
Practice Address - State:TX
Practice Address - Zip Code:77371-3582
Practice Address - Country:US
Practice Address - Phone:936-628-3396
Practice Address - Fax:936-628-3841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)