Provider Demographics
NPI:1942341359
Name:DELTA GREELY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:DELTA GREELY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST. SUPT.
Authorized Official - Prefix:
Authorized Official - First Name:LAURAL
Authorized Official - Middle Name:A
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-895-4657
Mailing Address - Street 1:PO BOX 527
Mailing Address - Street 2:
Mailing Address - City:DELTA JUNCTION
Mailing Address - State:AK
Mailing Address - Zip Code:99737-0527
Mailing Address - Country:US
Mailing Address - Phone:907-895-4657
Mailing Address - Fax:907-895-4781
Practice Address - Street 1:2659 NISTLER RD
Practice Address - Street 2:
Practice Address - City:DELTA JUNCTION
Practice Address - State:AK
Practice Address - Zip Code:99737
Practice Address - Country:US
Practice Address - Phone:907-895-4696
Practice Address - Fax:907-895-4051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKSB8954Medicaid