Provider Demographics
NPI:1629105309
Name:WELLTON SCHOOL DISTRICT
Entity Type:Organization
Organization Name:WELLTON SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:L
Authorized Official - Last Name:NOEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-785-3311
Mailing Address - Street 1:PO BOX 517
Mailing Address - Street 2:
Mailing Address - City:WELLTON
Mailing Address - State:AZ
Mailing Address - Zip Code:85356-0517
Mailing Address - Country:US
Mailing Address - Phone:928-785-3311
Mailing Address - Fax:928-785-4323
Practice Address - Street 1:29126 SAN JOSE AVE.
Practice Address - Street 2:
Practice Address - City:WELLTON
Practice Address - State:AZ
Practice Address - Zip Code:85356
Practice Address - Country:US
Practice Address - Phone:928-785-3311
Practice Address - Fax:928-785-4323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ855504251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ855504OtherPROVIDER NUMBER