Wood River Waldorf Methods School, a Public Charter School, Inc.

Primary specialty

Local Education Agency (LEA)Taxonomy code 251300000X

Legal business name

WOOD RIVER WALDORF METHODS SCHOOL, A PUBLIC CHARTER SCHOOL, INC.

Doing business as

Syringa Mountain School

Practice address

4021 Glenbrook Dr
Hailey, ID 83333-8516

Phone

(208) 806-2880

Fax

(208) 788-2464

NPI assigned

Jan 10, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mary Gervase, PHD

Title

Director

Phone

(208) 806-2880

Specialties & licenses 1

Addresses

Other names 1

• Syringa Mountain School Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1420848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420848000000",
    "number": "1619366911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4021 GLENBROOK DR",
            "city": "HAILEY",
            "state": "ID",
            "postal_code": "833338516",
            "telephone_number": "208-806-2880",
            "fax_number": "208-788-2464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4021 GLENBROOK DR",
            "city": "HAILEY",
            "state": "ID",
            "postal_code": "833338516",
            "telephone_number": "208-806-2880",
            "fax_number": "208-788-2464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOOD RIVER WALDORF METHODS SCHOOL, A PUBLIC CHARTER SCHOOL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-10",
        "last_updated": "2015-01-10",
        "status": "A",
        "authorized_official_last_name": "GERVASE",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "208-806-2880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Syringa Mountain School",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Wood River Family Medicine PLLC
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• Kathryn A Woods, M.D.
• Emily Zell, LMSW

• Local Education Agency (LEA) in Hailey, ID
• Providers in Hailey, ID by specialty
• Local Education Agency (LEA) in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.