Provider Demographics
NPI:1730214479
Name:FORESTVILLE UNION ELEMENTARY SCHOOL DISTRICT
Entity type:Organization
Organization Name:FORESTVILLE UNION ELEMENTARY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR OF SPECIAL EDUCATION
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:OLMSTED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-887-2279
Mailing Address - Street 1:6321 HWY 116
Mailing Address - Street 2:
Mailing Address - City:FORESTVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95436-9606
Mailing Address - Country:US
Mailing Address - Phone:707-887-2279
Mailing Address - Fax:707-887-2185
Practice Address - Street 1:6321 HWY 116
Practice Address - Street 2:
Practice Address - City:FORESTVILLE
Practice Address - State:CA
Practice Address - Zip Code:95436-9606
Practice Address - Country:US
Practice Address - Phone:707-887-2279
Practice Address - Fax:707-887-2185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 4683251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASS4970680Medicaid