Provider Demographics
NPI:1356628218
Name:SUPERSTITION MOUNTAIN ELEMETARY SCHOOL
Entity Type:Organization
Organization Name:SUPERSTITION MOUNTAIN ELEMETARY SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:
Authorized Official - First Name:INITIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCARTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-677-7520
Mailing Address - Street 1:550 S IRONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:APACHE JUNCTION
Mailing Address - State:AZ
Mailing Address - Zip Code:85120-5002
Mailing Address - Country:US
Mailing Address - Phone:480-677-7520
Mailing Address - Fax:
Practice Address - Street 1:550 S IRONWOOD DR
Practice Address - Street 2:
Practice Address - City:APACHE JUNCTION
Practice Address - State:AZ
Practice Address - Zip Code:85120-5002
Practice Address - Country:US
Practice Address - Phone:480-677-7520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:APACHE JUNCTION UNIFIED SCHOOL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-11-07
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)