Provider Demographics
NPI:1699029652
Name:MONTE VISTA SCHOOL
Entity Type:Organization
Organization Name:MONTE VISTA SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL NURSE
Authorized Official - Prefix:
Authorized Official - First Name:DASCHELLE
Authorized Official - Middle Name:C
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:602-381-6140
Mailing Address - Street 1:3501 E OSBORN RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-5767
Mailing Address - Country:US
Mailing Address - Phone:602-381-6140
Mailing Address - Fax:602-381-6159
Practice Address - Street 1:3501 E. OSBORN ROAD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018
Practice Address - Country:US
Practice Address - Phone:602-381-6140
Practice Address - Fax:602-381-6159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-30
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLP048666251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)