Provider Demographics
NPI:1972523413
Name:MISSION VALLEY USD 330
Entity Type:Organization
Organization Name:MISSION VALLEY USD 330
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-449-2871
Mailing Address - Street 1:PO BOX 189
Mailing Address - Street 2:
Mailing Address - City:GIRARD
Mailing Address - State:KS
Mailing Address - Zip Code:66743-0189
Mailing Address - Country:US
Mailing Address - Phone:620-724-6281
Mailing Address - Fax:620-724-7141
Practice Address - Street 1:12685 MISSION VALLEY RD
Practice Address - Street 2:SUITE C
Practice Address - City:ESKRIDGE
Practice Address - State:KS
Practice Address - Zip Code:66423-8910
Practice Address - Country:US
Practice Address - Phone:785-449-2871
Practice Address - Fax:785-449-2260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100212140AMedicaid