Provider Demographics
NPI:1578198925
Name:ALPINE UNION ELEMENTARY
Entity Type:Organization
Organization Name:ALPINE UNION ELEMENTARY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BURDETTE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:619-445-3236
Mailing Address - Street 1:2001 TAVERN RD
Mailing Address - Street 2:
Mailing Address - City:ALPINE
Mailing Address - State:CA
Mailing Address - Zip Code:91901-3129
Mailing Address - Country:US
Mailing Address - Phone:619-445-3236
Mailing Address - Fax:619-445-7045
Practice Address - Street 1:2001 TAVERN RD
Practice Address - Street 2:
Practice Address - City:ALPINE
Practice Address - State:CA
Practice Address - Zip Code:91901-3129
Practice Address - Country:US
Practice Address - Phone:619-445-3236
Practice Address - Fax:619-445-7045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-05
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)