Provider Demographics
NPI:1205074895
Name:WESTERN LOCAL SCHOOL DISTRICT
Entity type:Organization
Organization Name:WESTERN LOCAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEETH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-493-3113
Mailing Address - Street 1:7959 STATE ROUTE 124
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:OH
Mailing Address - Zip Code:45646-9701
Mailing Address - Country:US
Mailing Address - Phone:740-493-3113
Mailing Address - Fax:740-493-2065
Practice Address - Street 1:7959 STATE ROUTE 124
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:OH
Practice Address - Zip Code:45646-9701
Practice Address - Country:US
Practice Address - Phone:740-493-3113
Practice Address - Fax:740-493-2065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH049155Medicaid