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General NPI Number Information
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NPI Number | 1689814378
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Entity Type | Organization
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Legal Business Name | EAGLE HEIGHTS ACADEMY
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Dates
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Enumeration Date | 02/20/2009
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Last Update Date | 02/20/2009
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Provider Practice Location Address
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Address Line | 1833 MARKET ST
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City | YOUNGSTOWN
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State | OH
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Zip | 44507-1137
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Country | US
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Telephone | 330-742-9090
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Fax | 330-743-1998
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Provider Business Mailing Address
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Address Line | 1833 MARKET ST
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City | YOUNGSTOWN
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State | OH
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Zip | 44507-1137
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Country | US
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Telephone | 330-742-9090
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Fax | 330-743-1998
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Authorized Official
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Title or Position | CHIEF ACADEMIC OFFICER
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Name | MR. JOHN BOOHER
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Credential |
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Telephone | 330-742-9090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number | 134080 134080
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License Number State | OH
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