Provider Demographics
NPI:1811474752
Name:GOAL DIGITAL ACADEMY
Entity type:Organization
Organization Name:GOAL DIGITAL ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:TISH
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATIVE LICEN
Authorized Official - Phone:419-775-4809
Mailing Address - Street 1:890 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:OH
Mailing Address - Zip Code:44906-2565
Mailing Address - Country:US
Mailing Address - Phone:419-775-4809
Mailing Address - Fax:
Practice Address - Street 1:890 W 4TH ST
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OH
Practice Address - Zip Code:44906-2565
Practice Address - Country:US
Practice Address - Phone:419-775-4809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-24
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)