Educational Service District 112

LBN: Educational Service District 112
Educational Service District 112 is an health care organization with primary practice located at 2500 Ne 65 Avenue , Vancouver WA 98661-6812. The organization recently has 4 registered licenses in different health care specialties including Agencies / Local Education Agency (LEA), Agencies / Case Management, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder. Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) is the primary health care specialty. Educational Service District 112 can be contacted via phone (360) 750-7500, or through Hottman, Gavin via phone (360) 750-7500.

Contact Information

Primary practice address
2500 Ne 65 Avenue Vancouver WA 98661-6812
Phone: (360) 750-7500
Fax: (360) 906-1010
Website:
Map and Directions
Authorized official contact:
Name: Hottman, Gavin
Phone: (360) 750-7500

Health care specialties

SpecialtyCodeLicense #State
Agencies / Local Education Agency (LEA) 251300000X
Agencies / Case Management 251B00000X
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X
Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder 261QR0405X Washington

Profile Details

NPI number 1790008928
LBN Legal business name Educational Service District 112
DBA Doing business as
Authorized official Hottman, Gavin
Entity Organization
Organization subpart 1 No
Enumeration date Mar 2nd, 2010
Last updated Nov 24th, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790008928 NPPES
Washington Other 1996008 CURRENT PROVIDER NUMBER TO BE USED WITH NPI

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