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General NPI Number Information
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NPI Number | 1790596104
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Entity Type | Organization
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Legal Business Name | ALDER GROVE CHARTER SCHOOL
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Dates
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Enumeration Date | 01/15/2025
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 714 F ST
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City | EUREKA
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State | CA
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Zip | 95501-1036
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Country | US
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Telephone | 707-268-0854
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Fax | 707-268-0813
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Provider Business Mailing Address
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Address Line | 714 F ST
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City | EUREKA
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State | CA
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Zip | 95501-1036
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Country | US
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Telephone | 707-268-0854
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Fax | 707-268-0813
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Authorized Official
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Title or Position | DIRECTOR OF SPECIAL SERVICES
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Name | NICHOLE DOLLARHIDE
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Credential | PPS, LEP
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Telephone | 707-572-0099
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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 |
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License Number State |
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