Provider Demographics
NPI:1053584128
Name:PERRIS UNION HIGH SCHOOL DISTRICT
Entity type:Organization
Organization Name:PERRIS UNION HIGH SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/SPECIAL EDUCATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARCY
Authorized Official - Middle Name:
Authorized Official - Last Name:SAVAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-943-6531
Mailing Address - Street 1:155 E 4TH ST
Mailing Address - Street 2:SPECIAL EDUCATION SERVICES
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92570-2124
Mailing Address - Country:US
Mailing Address - Phone:951-943-6531
Mailing Address - Fax:951-943-6501
Practice Address - Street 1:755-B NORTH A STREET
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92570
Practice Address - Country:US
Practice Address - Phone:951-943-6531
Practice Address - Fax:951-943-6501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-09
Last Update Date:2008-08-01
Deactivation Date:2008-06-03
Deactivation Code:
Reactivation Date:2008-08-01
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASS3367207Medicaid