Provider Demographics
NPI:1952452740
Name:HOLLAND PATENT CENTRAL SCHOOL DISTRICT
Entity Type:Organization
Organization Name:HOLLAND PATENT CENTRAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-865-7221
Mailing Address - Street 1:9601 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HOLLAND PATENT
Mailing Address - State:NY
Mailing Address - Zip Code:13354-4618
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9601 MAIN ST
Practice Address - Street 2:
Practice Address - City:HOLLAND PATENT
Practice Address - State:NY
Practice Address - Zip Code:13354-4618
Practice Address - Country:US
Practice Address - Phone:315-865-7221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY412201060000251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01390578Medicaid