Provider Demographics
NPI:1326162769
Name:GRAYSLAKE CC DISTRICT 46
Entity Type:Organization
Organization Name:GRAYSLAKE CC DISTRICT 46
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:LORENZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-543-5322
Mailing Address - Street 1:450 BARRON BLVD
Mailing Address - Street 2:
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-1666
Mailing Address - Country:US
Mailing Address - Phone:847-543-5322
Mailing Address - Fax:
Practice Address - Street 1:450 BARRON BLVD
Practice Address - Street 2:
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-1666
Practice Address - Country:US
Practice Address - Phone:847-543-5322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)