Provider Demographics
NPI:1346489622
Name:OHIO VIRTUAL ACADEMY
Entity type:Organization
Organization Name:OHIO VIRTUAL ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEAD OF SCHOOL
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-482-0948
Mailing Address - Street 1:1655 HOLLAND RD STE F
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-1656
Mailing Address - Country:US
Mailing Address - Phone:419-482-0948
Mailing Address - Fax:419-482-0954
Practice Address - Street 1:1655 HOLLAND RD STE F
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-1656
Practice Address - Country:US
Practice Address - Phone:419-482-0948
Practice Address - Fax:419-482-0954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-11
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251300000X251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)