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General NPI Number Information
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NPI Number | 1174677603
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Entity Type | Organization
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Legal Business Name | VALLIVUE SCHOOL DISTRICT #139
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 09/22/2009
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Provider Practice Location Address
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Address Line | 5207 S MONTANA AVE
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City | CALDWELL
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State | ID
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Zip | 83607-1583
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Country | US
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Telephone | 208-454-0445
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Fax | 208-454-0778
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Provider Business Mailing Address
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Address Line | 5207 S MONTANA AVE
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City | CALDWELL
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State | ID
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Zip | 83607-1583
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Country | US
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Telephone | 208-454-0445
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Fax | 208-454-0778
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Authorized Official
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Title or Position | SUPERINTENDENT
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Name | MR. GEORGE GRANT
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Credential |
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Telephone | 208-454-0445
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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 | ID
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