1053584128 NPI number — PERRIS UNION HIGH SCHOOL DISTRICT

Table of content: (NPI 1053584128)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053584128 NPI number — PERRIS UNION HIGH SCHOOL DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PERRIS UNION HIGH SCHOOL DISTRICT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053584128
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/01/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
06/03/2008
NPI Reactivation Date:
08/01/2008

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
155 E 4TH ST
Provider Second Line Business Mailing Address:
SPECIAL EDUCATION SERVICES
Provider Business Mailing Address City Name:
PERRIS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92570-2124
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
951-943-6531
Provider Business Mailing Address Fax Number:
951-943-6501

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
755-B NORTH A STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PERRIS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92570
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
951-943-6531
Provider Business Practice Location Address Fax Number:
951-943-6501
Provider Enumeration Date:
04/09/2008

Additional Information

Authorized Official

Authorized Official Last Name:
SAVAGE
Authorized Official First Name:
MARCY
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR/SPECIAL EDUCATION
Authorized Official Telephone Number:
951-943-6531

Provider Taxonomy Codes

  • Taxonomy code: 251300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: SS3367207 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com