Provider Demographics
NPI:1811087968
Name:BENTON COUNTY SCHOOL DISTRICT 7J
Entity type:Organization
Organization Name:BENTON COUNTY SCHOOL DISTRICT 7J
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GWEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUNEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-487-4305
Mailing Address - Street 1:301 S 3RD STREET
Mailing Address - Street 2:PO BOX B
Mailing Address - City:ALSEA
Mailing Address - State:OR
Mailing Address - Zip Code:97324-0120
Mailing Address - Country:US
Mailing Address - Phone:541-487-4305
Mailing Address - Fax:541-487-4089
Practice Address - Street 1:301 S 3RD STREET
Practice Address - Street 2:
Practice Address - City:ALSEA
Practice Address - State:OR
Practice Address - Zip Code:97324-0120
Practice Address - Country:US
Practice Address - Phone:541-487-4305
Practice Address - Fax:541-487-4089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR048269Medicaid