Provider Demographics
NPI:1508070194
Name:WATERVILLEL VALLEY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:WATERVILLEL VALLEY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL EDUCATION
Authorized Official - Prefix:
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:
Authorized Official - Last Name:GONSALVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-536-1254
Mailing Address - Street 1:47 OLD WARD BRIDGE ROAD
Mailing Address - Street 2:SAU 48
Mailing Address - City:PLYMOUTH
Mailing Address - State:NV
Mailing Address - Zip Code:03264
Mailing Address - Country:US
Mailing Address - Phone:603-536-1254
Mailing Address - Fax:
Practice Address - Street 1:1 NOON PEAK ROAD
Practice Address - Street 2:WATERVILLE VALLEY SCHOOL DISTRICT
Practice Address - City:WATERVILLE VALLEY
Practice Address - State:NH
Practice Address - Zip Code:03215
Practice Address - Country:US
Practice Address - Phone:603-536-1254
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH50004134Medicaid