Provider Demographics
NPI:1356477004
Name:MORRISTOWN ELEMENTARY SCHOOL DISTRICT 75
Entity Type:Organization
Organization Name:MORRISTOWN ELEMENTARY SCHOOL DISTRICT 75
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL ED DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LUCILLE
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-388-2336
Mailing Address - Street 1:PO BOX 98
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:AZ
Mailing Address - Zip Code:85342-0098
Mailing Address - Country:US
Mailing Address - Phone:623-388-2336
Mailing Address - Fax:623-388-9368
Practice Address - Street 1:25950 ROCKAWAY HILLS DRIVE
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:AZ
Practice Address - Zip Code:85342
Practice Address - Country:US
Practice Address - Phone:623-388-2336
Practice Address - Fax:623-388-9368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
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
AZ704313Medicaid