Provider Demographics
NPI:1336233675
Name:CHEBOYGAN-OTSEGO-PRESQUE ISLE E.S.D.
Entity Type:Organization
Organization Name:CHEBOYGAN-OTSEGO-PRESQUE ISLE E.S.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL EDUCATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-238-9394
Mailing Address - Street 1:6065 LEARNING LN
Mailing Address - Street 2:
Mailing Address - City:INDIAN RIVER
Mailing Address - State:MI
Mailing Address - Zip Code:49749-9357
Mailing Address - Country:US
Mailing Address - Phone:231-238-9394
Mailing Address - Fax:231-238-8551
Practice Address - Street 1:6065 LEARNING LN
Practice Address - Street 2:
Practice Address - City:INDIAN RIVER
Practice Address - State:MI
Practice Address - Zip Code:49749-9357
Practice Address - Country:US
Practice Address - Phone:231-238-9394
Practice Address - Fax:231-238-8551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
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
MI3032625Medicaid