Provider Demographics
NPI:1790001204
Name:COLORADO CITY UNIFIED SCHOOL DISTRICT
Entity Type:Organization
Organization Name:COLORADO CITY UNIFIED SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:TIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-875-9000
Mailing Address - Street 1:255 NORTH COTTONWOOD STREET
Mailing Address - Street 2:
Mailing Address - City:COLORADO CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86021-0309
Mailing Address - Country:US
Mailing Address - Phone:928-875-9000
Mailing Address - Fax:928-875-8068
Practice Address - Street 1:325 NORTH COTTONWOOD STREET
Practice Address - Street 2:
Practice Address - City:COLORADO CITY
Practice Address - State:AZ
Practice Address - Zip Code:86021-0309
Practice Address - Country:US
Practice Address - Phone:928-875-9000
Practice Address - Fax:928-875-8068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-09
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA6408235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty