Provider Demographics
NPI:1952349391
Name:CASTLE ROCK SCHOOL DISTRICT #401
Entity type:Organization
Organization Name:CASTLE ROCK SCHOOL DISTRICT #401
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM SUPERINTENDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-501-2940
Mailing Address - Street 1:600 HUNTINGTON AVE S
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:WA
Mailing Address - Zip Code:98611-8901
Mailing Address - Country:US
Mailing Address - Phone:360-501-2940
Mailing Address - Fax:360-501-3140
Practice Address - Street 1:600 HUNTINGTON AVE S
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:WA
Practice Address - Zip Code:98611-8901
Practice Address - Country:US
Practice Address - Phone:360-501-2940
Practice Address - Fax:360-501-3140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7440373Medicaid