=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619017639
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FRANKLIN PHONETIC PRIMARY SCHOOL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/07/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6116 E. HWY 69
-----------------------------------------------------
City | PRESCOTT VALLEY
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 86314
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 928-775-6747
-----------------------------------------------------
Fax | 928-775-6740
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6116 E. HWY 69
-----------------------------------------------------
City | PRESCOTT VALLEY
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 86314
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 928-775-6747
-----------------------------------------------------
Fax | 928-775-6740
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | BUSINESS MANAGER
-----------------------------------------------------
Name | MRS. CANDACE L ANDREWS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 928-775-6747
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251300000X
-----------------------------------------------------
Taxonomy Name | Local Education Agency (LEA)
-----------------------------------------------------
License Number | 557077
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------