Provider Demographics
NPI:1356530356
Name:ARCATA SCHOOL DISTRICT
Entity type:Organization
Organization Name:ARCATA SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:PARISI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-822-0351
Mailing Address - Street 1:1435 BUTTERMILK LN
Mailing Address - Street 2:
Mailing Address - City:ARCATA
Mailing Address - State:CA
Mailing Address - Zip Code:95521-6909
Mailing Address - Country:US
Mailing Address - Phone:707-822-0351
Mailing Address - Fax:707-822-6589
Practice Address - Street 1:1435 BUTTERMILK LN
Practice Address - Street 2:
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-6909
Practice Address - Country:US
Practice Address - Phone:707-822-0351
Practice Address - Fax:707-822-6589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASS1262679251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASS1262679OtherMEDI-CAL PROVIDER NUMBER