Provider Demographics
NPI:1891550356
Name:SAMARA LEARNING CENTER
Entity Type:Organization
Organization Name:SAMARA LEARNING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:BROOKE
Authorized Official - Last Name:CHATEM
Authorized Official - Suffix:
Authorized Official - Credentials:MA, ACL
Authorized Official - Phone:541-419-3324
Mailing Address - Street 1:230 NE 9TH ST LOWR LOT 1
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-5137
Mailing Address - Country:US
Mailing Address - Phone:541-419-3324
Mailing Address - Fax:
Practice Address - Street 1:230 NE 9TH ST LOWR LOT 1
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-5137
Practice Address - Country:US
Practice Address - Phone:541-419-3324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-14
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR01733538-6OtherOREGON BUSINESS REGISTRATION
OR48992OtherCHARITABLE ACTIVITIES REGISTRATION