Provider Demographics
NPI:1154502490
Name:APACHE JUNCTION UNIFIED SCHOOL DISTRICT #43
Entity Type:Organization
Organization Name:APACHE JUNCTION UNIFIED SCHOOL DISTRICT #43
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL EDUCATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MEJIA
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:480-982-1110
Mailing Address - Street 1:1575 W SOUTHERN AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:APACHE JUNCTION
Mailing Address - State:AZ
Mailing Address - Zip Code:85220-7456
Mailing Address - Country:US
Mailing Address - Phone:480-982-1110
Mailing Address - Fax:480-983-6497
Practice Address - Street 1:1575 W SOUTHERN AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:APACHE JUNCTION
Practice Address - State:AZ
Practice Address - Zip Code:85220-7456
Practice Address - Country:US
Practice Address - Phone:480-982-1110
Practice Address - Fax:480-983-6497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3682595103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ968969OtherAHCCCS