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General NPI Number Information
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NPI Number | 1184851313
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Entity Type | Organization
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Legal Business Name | NORTH VALLEY ACADEMY CHARTER SCHOOL
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Dates
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Enumeration Date | 06/15/2009
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Last Update Date | 06/15/2009
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Provider Practice Location Address
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Address Line | 202 14TH AVE E
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City | GOODING
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State | ID
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Zip | 83330-1829
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Country | US
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Telephone | 208-934-4567
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Fax | 208-934-4522
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Provider Business Mailing Address
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Address Line | 202 14TH AVE E
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City | GOODING
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State | ID
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Zip | 83330-1829
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Country | US
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Telephone | 208-934-4567
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Fax | 208-934-4522
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Authorized Official
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Title or Position | PRINCIPAL
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Name | JUDY KAY STUDEBAKER
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Credential | M. ED
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Telephone | 208-934-4567
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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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