Provider Demographics
NPI:1255354684
Name:LANE COUNTY SCHOOL DISTRICT 97J
Entity type:Organization
Organization Name:LANE COUNTY SCHOOL DISTRICT 97J
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SPECIAL PROGRAMS DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:WINTERSCHEID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-997-2651
Mailing Address - Street 1:2111 OAK ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:OR
Mailing Address - Zip Code:97439-9409
Mailing Address - Country:US
Mailing Address - Phone:541-997-2651
Mailing Address - Fax:541-997-6748
Practice Address - Street 1:2111 OAK ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:OR
Practice Address - Zip Code:97439-9409
Practice Address - Country:US
Practice Address - Phone:541-997-2651
Practice Address - Fax:541-997-6748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR165020Medicaid