Provider Demographics
NPI:1275753691
Name:COACHELLA VALLEY UNIFIED SCHOOL DISTRICT
Entity Type:Organization
Organization Name:COACHELLA VALLEY UNIFIED SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST. SUPERINTENDENT, BUSINESS SERV
Authorized Official - Prefix:MS
Authorized Official - First Name:CAREY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-399-5137
Mailing Address - Street 1:87225 CHURCH STREET
Mailing Address - Street 2:
Mailing Address - City:THERMAL
Mailing Address - State:CA
Mailing Address - Zip Code:92274
Mailing Address - Country:US
Mailing Address - Phone:760-399-5137
Mailing Address - Fax:760-399-1310
Practice Address - Street 1:87225 CHURCH STREET
Practice Address - Street 2:
Practice Address - City:THERMAL
Practice Address - State:CA
Practice Address - Zip Code:92274
Practice Address - Country:US
Practice Address - Phone:760-399-5137
Practice Address - Fax:760-399-1310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASS3373676Medicaid