Provider Demographics
NPI:1184292849
Name:SHRUB OAK INTERNATIONAL SCHOOL, LLC
Entity type:Organization
Organization Name:SHRUB OAK INTERNATIONAL SCHOOL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:STEYSKAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-885-0110
Mailing Address - Street 1:3151 STONY STREET
Mailing Address - Street 2:SHRUB OAK INTERNATIONAL SCHOOL
Mailing Address - City:MOHEGAN LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:10547
Mailing Address - Country:US
Mailing Address - Phone:914-885-0110
Mailing Address - Fax:914-245-8500
Practice Address - Street 1:3151 STONY STREET
Practice Address - Street 2:SHRUB OAK INTERNATIONAL SCHOOL
Practice Address - City:MOHEGAN LAKE
Practice Address - State:NY
Practice Address - Zip Code:10547
Practice Address - Country:US
Practice Address - Phone:914-885-0110
Practice Address - Fax:914-245-8500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-17
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services