Provider Demographics
NPI:1154508372
Name:LAVEN ELEMENTARY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:LAVEN ELEMENTARY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHELAGH
Authorized Official - Middle Name:P
Authorized Official - Last Name:MURPHY REYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-237-9120
Mailing Address - Street 1:9401 S 51ST AVE
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-2710
Mailing Address - Country:US
Mailing Address - Phone:602-237-9100
Mailing Address - Fax:
Practice Address - Street 1:3851 W ROESER RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85041-2615
Practice Address - Country:US
Practice Address - Phone:602-237-9120
Practice Address - Fax:602-237-9133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ728959Medicaid