Provider Demographics
NPI:1306943535
Name:NYSSA SCHOOL DISTRICT #26
Entity type:Organization
Organization Name:NYSSA SCHOOL DISTRICT #26
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:GROTTING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-372-2275
Mailing Address - Street 1:804 ADRIAN BLVD
Mailing Address - Street 2:
Mailing Address - City:NYSSA
Mailing Address - State:OR
Mailing Address - Zip Code:97913-3642
Mailing Address - Country:US
Mailing Address - Phone:541-372-2204
Mailing Address - Fax:541-473-3915
Practice Address - Street 1:804 ADRIAN BLVD
Practice Address - Street 2:
Practice Address - City:NYSSA
Practice Address - State:OR
Practice Address - Zip Code:97913-3642
Practice Address - Country:US
Practice Address - Phone:541-372-2204
Practice Address - Fax:541-473-3915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR135967Medicaid