Provider Demographics
NPI:1578670451
Name:ALPINE SCHOOL DISTRICT
Entity Type:Organization
Organization Name:ALPINE SCHOOL DISTRICT
Other - Org Name:ALPINE SCHOOL DISTRICT PRE-SCHOOL
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAID MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARJORIE
Authorized Official - Middle Name:SUSAN
Authorized Official - Last Name:HORNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-756-6060
Mailing Address - Street 1:169 N 1100 E
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-2917
Mailing Address - Country:US
Mailing Address - Phone:801-756-6060
Mailing Address - Fax:801-756-6060
Practice Address - Street 1:169 N 1100 E
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2917
Practice Address - Country:US
Practice Address - Phone:801-756-6060
Practice Address - Fax:801-756-6060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)