Provider Demographics
NPI:1811081623
Name:SWEET HOME SCHOOL DISTRICT 55
Entity type:Organization
Organization Name:SWEET HOME SCHOOL DISTRICT 55
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:STRONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-367-7113
Mailing Address - Street 1:1920 LONG ST
Mailing Address - Street 2:
Mailing Address - City:SWEET HOME
Mailing Address - State:OR
Mailing Address - Zip Code:97386-2324
Mailing Address - Country:US
Mailing Address - Phone:541-367-7113
Mailing Address - Fax:541-367-7105
Practice Address - Street 1:1920 LONG ST
Practice Address - Street 2:
Practice Address - City:SWEET HOME
Practice Address - State:OR
Practice Address - Zip Code:97386-2324
Practice Address - Country:US
Practice Address - Phone:541-367-7113
Practice Address - Fax:541-367-7105
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
OR048178Medicaid