Provider Demographics
NPI:1477689933
Name:WICKENBURG UNIFIED SCHOOL DISTRICT #9
Entity Type:Organization
Organization Name:WICKENBURG UNIFIED SCHOOL DISTRICT #9
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MORAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-684-6714
Mailing Address - Street 1:40 W YAVAPAI ST
Mailing Address - Street 2:
Mailing Address - City:WICKENBURG
Mailing Address - State:AZ
Mailing Address - Zip Code:85390-3201
Mailing Address - Country:US
Mailing Address - Phone:928-668-5350
Mailing Address - Fax:928-668-5390
Practice Address - Street 1:920 S. VULTURE MINE ROAD
Practice Address - Street 2:SPECIAL EDUCATION OFFICE
Practice Address - City:WICKENBURG
Practice Address - State:AZ
Practice Address - Zip Code:85390
Practice Address - Country:US
Practice Address - Phone:928-684-6714
Practice Address - Fax:928-684-6711
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 Licenses
StateLicense IDTaxonomies
AZ07-288820-F251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ965676OtherAHCCCS PROVIDER NUMBER