MEDICARE: GUADELUPE EDUCATIONAL SYSTEMS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1992058135
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUADELUPE EDUCATIONAL SYSTEMS INC

Provider Business Mailing Address
First Line	:	1015 AVENIDA CESAR E CHAVEZ
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64108-2235
Country	:	US
Telephone Number	:	816-421-1015
Fax Number	:

Provider Business Practice Location Address
First Line	:	1015 AVENIDA CESAR E CHAVEZ
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64108-2235
Country	:	US
Telephone Number	:	816-421-1015
Fax Number	:

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	GILBERT GUERRERO
Credential	:
Telephone Number	:	816-421-1015

Provider Enumeration Date	:	10/25/2012
Last Update Date	:	10/25/2012

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