Provider Demographics
NPI:1245715945
Name:PEACE VALLEY CHARTER SCHOOL
Entity type:Organization
Organization Name:PEACE VALLEY CHARTER SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:HENNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-340-4498
Mailing Address - Street 1:1845 S FEDERAL WAY
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705-4261
Mailing Address - Country:US
Mailing Address - Phone:208-205-8818
Mailing Address - Fax:208-485-7212
Practice Address - Street 1:1845 S FEDERAL WAY
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-4261
Practice Address - Country:US
Practice Address - Phone:208-205-8818
Practice Address - Fax:208-485-7212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)