Provider Demographics
NPI:1447815493
Name:PRESCOTT VALLEY CHARTER SCHOOL
Entity type:Organization
Organization Name:PRESCOTT VALLEY CHARTER SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:NIKKI
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTEGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-354-4881
Mailing Address - Street 1:3838 N CENTRAL AVE STE 1600
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-1950
Mailing Address - Country:US
Mailing Address - Phone:800-354-4881
Mailing Address - Fax:602-926-2445
Practice Address - Street 1:9500 E LORNA LN
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-2324
Practice Address - Country:US
Practice Address - Phone:928-772-8744
Practice Address - Fax:602-926-2445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-06
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)