Organization
LAVEEN SCHOOL DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI CANISALES (CONTACT PERSON)
(602) 237-9100
Entity
Organization
Contact information
Practice address
7275 WEST VINEYARD ROAD, LAVEEN, AZ 85339
(602) 605-8540
Mailing address
9401 S 51ST AVE, LAVEEN, AZ 85339-2710
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
SLP5760
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SLP5760
—
AZ
Enumeration date
02/07/2008
Last updated
02/07/2008
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