Healthcare Provider Details

I. General information

NPI: 1275858854
Provider Name (Legal Business Name): HOOD RIVER COUNTY SCHOOL DISTRICT EI/ECSE PROGRAM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2010
Last Update Date: 04/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 FRANKTON RD
HOOD RIVER OR
97031-9737
US

IV. Provider business mailing address

1011 EUGENE ST
HOOD RIVER OR
97031-1415
US

V. Phone/Fax

Practice location:
  • Phone: 541-387-5077
  • Fax: 541-387-3506
Mailing address:
  • Phone: 541-387-5010
  • Fax: 541-387-5099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. NICK HOGAN
Title or Position: BUSINESS MANAGER/DEPUTY CLERK
Credential:
Phone: 541-387-5010