Provider Demographics
NPI:1952636334
Name:PARADISE-NATOMA
Entity Type:Organization
Organization Name:PARADISE-NATOMA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:TRENT
Authorized Official - Last Name:HOMBURG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-885-4478
Mailing Address - Street 1:710 5TH STREET
Mailing Address - Street 2:
Mailing Address - City:NATOMA
Mailing Address - State:KS
Mailing Address - Zip Code:67651
Mailing Address - Country:US
Mailing Address - Phone:785-885-4478
Mailing Address - Fax:785-885-4479
Practice Address - Street 1:710 5TH ST
Practice Address - Street 2:
Practice Address - City:NATOMA
Practice Address - State:KS
Practice Address - Zip Code:67651-9744
Practice Address - Country:US
Practice Address - Phone:785-885-4478
Practice Address - Fax:785-885-4479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-02
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)