Provider Demographics
NPI:1134425218
Name:HACKBERRY SCHOOL DISTRICT#3
Entity type:Organization
Organization Name:HACKBERRY SCHOOL DISTRICT#3
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TK
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-692-0013
Mailing Address - Street 1:9501 E NELLIE DR
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86401-8917
Mailing Address - Country:US
Mailing Address - Phone:928-692-0013
Mailing Address - Fax:928-692-1075
Practice Address - Street 1:9501 E NELLIE DR
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86401-8917
Practice Address - Country:US
Practice Address - Phone:928-692-0013
Practice Address - Fax:928-692-1075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)