Provider Demographics
NPI:1659494037
Name:ABC UNIFIED SCHOOL DISTRICT
Entity Type:Organization
Organization Name:ABC UNIFIED SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR-PUPIL SUPPORT SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVY-CRAVEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-926-5566
Mailing Address - Street 1:16700 NORWALK BLVD
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-1838
Mailing Address - Country:US
Mailing Address - Phone:562-926-5566
Mailing Address - Fax:562-926-5627
Practice Address - Street 1:16700 NORWALK BLVD
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-1838
Practice Address - Country:US
Practice Address - Phone:562-926-5566
Practice Address - Fax:562-926-5627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASS1964212Medicaid