Provider Demographics
NPI:1124240452
Name:COUNTY OF LATAH JOINT SCHOOL DISTRICT 283
Entity type:Organization
Organization Name:COUNTY OF LATAH JOINT SCHOOL DISTRICT 283
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISTRICT SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:EICHNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-289-4211
Mailing Address - Street 1:2001 HIGHWAY 3
Mailing Address - Street 2:P.O. BOX 283
Mailing Address - City:KENDRICK
Mailing Address - State:ID
Mailing Address - Zip Code:83537-9739
Mailing Address - Country:US
Mailing Address - Phone:208-289-4211
Mailing Address - Fax:
Practice Address - Street 1:2001 HIGHWAY 3
Practice Address - Street 2:
Practice Address - City:KENDRICK
Practice Address - State:ID
Practice Address - Zip Code:83537-9739
Practice Address - Country:US
Practice Address - Phone:208-289-4211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID80656252355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Multi-Specialty