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General NPI Number Information
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NPI Number | 1104308691
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Entity Type | Organization
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Legal Business Name | GREATER ANAHEIM SPECIAL EDUCATION LOCAL PLAN AREA
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Dates
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Enumeration Date | 08/31/2018
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Last Update Date | 09/17/2018
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Provider Practice Location Address
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Address Line | 7300 LA PALMA AVE BLDG 6
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City | BUENA PARK
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State | CA
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Zip | 90620-2623
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Country | US
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Telephone | 714-796-8960
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Fax | 714-828-6783
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Provider Business Mailing Address
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Address Line | 7300 LA PALMA AVE BLDG 6
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City | BUENA PARK
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State | CA
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Zip | 90620-2623
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Country | US
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Telephone | 714-796-8960
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Fax | 714-828-6783
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | PAUL LAVIGNE
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Credential | ED.D.
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Telephone | 714-796-8963
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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