Healthcare Provider Details

I. General information

NPI: 1275837213
Provider Name (Legal Business Name): DYSART UNIFIED SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2011
Last Update Date: 01/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17999 W SURPRISE FARMS LOOP S
SURPRISE AZ
85388-6641
US

IV. Provider business mailing address

17999 W SURPRISE FARMS LOOP S
SURPRISE AZ
85388-6641
US

V. Phone/Fax

Practice location:
  • Phone: 623-876-7351
  • Fax: 623-876-7361
Mailing address:
  • Phone: 623-876-7351
  • Fax: 623-876-7361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: RITA ANN DONOHUE
Title or Position: SCHOOL NURSE
Credential: RN
Phone: 623-876-7351