Healthcare Provider Details

I. General information

NPI: 1730368127
Provider Name (Legal Business Name): LITTLEFIELD UNIFIED SCHOOL DISTRICT #9
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2007
Last Update Date: 11/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3436 E RIO VIRGIN RD
BEAVER DAM AZ
86432-0730
US

IV. Provider business mailing address

PO BOX 730
BEAVER DAM AZ
86432-0730
US

V. Phone/Fax

Practice location:
  • Phone: 928-347-5796
  • Fax: 928-347-5795
Mailing address:
  • Phone: 928-347-5796
  • Fax: 928-347-5795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. KIM SAVAQGE-WINN
Title or Position: SPECIAL EDUCATION DIRECTOR
Credential:
Phone: 928-347-5796