Provider Demographics
NPI:1154528453
Name:BLACK RIVER LOCAL SCHOOLS
Entity type:Organization
Organization Name:BLACK RIVER LOCAL SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:WYCKOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-736-3300
Mailing Address - Street 1:257A CO RD 40
Mailing Address - Street 2:
Mailing Address - City:SULLIVAN
Mailing Address - State:OH
Mailing Address - Zip Code:44880
Mailing Address - Country:US
Mailing Address - Phone:419-736-3300
Mailing Address - Fax:419-736-3308
Practice Address - Street 1:257A CO RD 40
Practice Address - Street 2:
Practice Address - City:SULLIVAN
Practice Address - State:OH
Practice Address - Zip Code:44880
Practice Address - Country:US
Practice Address - Phone:419-736-3300
Practice Address - Fax:419-736-3308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)