Organization
MESA UNIFIED SCHOOL DISTRICT NO. 4
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALBERTA LONGACRE (DIRECTOR MEDICAID MONITORING)
(480) 472-0685
Entity
Organization
Contact information
Practice address
1025 N COUNTRY CLUB DR, MESA, AZ 85201-3302
(480) 472-0685
(480) 472-0705
Mailing address
1025 N COUNTRY CLUB DR, MESA, AZ 85201-3302
(480) 472-0685
(480) 472-0705
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
568991
—
AZ
Enumeration date
02/02/2007
Last updated
08/22/2020
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