Provider Demographics
NPI:1043479900
Name:RIVENDELL INTERSTATE SCHOOL DISTRICT
Entity type:Organization
Organization Name:RIVENDELL INTERSTATE SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:NEEDHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-353-2170
Mailing Address - Street 1:10 SCHOOL DR
Mailing Address - Street 2:
Mailing Address - City:ORFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03777-4536
Mailing Address - Country:US
Mailing Address - Phone:603-353-2170
Mailing Address - Fax:603-353-2189
Practice Address - Street 1:10 SCHOOL DR
Practice Address - Street 2:
Practice Address - City:ORFORD
Practice Address - State:NH
Practice Address - Zip Code:03777-4536
Practice Address - Country:US
Practice Address - Phone:603-353-2170
Practice Address - Fax:603-353-2189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-05
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH50500093Medicaid