Provider Demographics
NPI:1003623349
Name:MODOC COUNTY JOINT UNIFIED SCHOOL DISTRICT
Entity type:Organization
Organization Name:MODOC COUNTY JOINT UNIFIED SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR MH SUPPORT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:ALISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMESHA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:530-233-7101
Mailing Address - Street 1:MODOC COUNTY OFFICE OF EDUCATION
Mailing Address - Street 2:139 HENDERSON STREET
Mailing Address - City:ALTURAS
Mailing Address - State:CA
Mailing Address - Zip Code:96101
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:809 W 8TH ST
Practice Address - Street 2:
Practice Address - City:ALTURAS
Practice Address - State:CA
Practice Address - Zip Code:96101-3116
Practice Address - Country:US
Practice Address - Phone:530-233-7101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)