Provider Demographics
NPI:1104308691
Name:GREATER ANAHEIM SPECIAL EDUCATION LOCAL PLAN AREA
Entity type:Organization
Organization Name:GREATER ANAHEIM SPECIAL EDUCATION LOCAL PLAN AREA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:LAVIGNE
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:714-796-8963
Mailing Address - Street 1:7300 LA PALMA AVE BLDG 6
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90620-2623
Mailing Address - Country:US
Mailing Address - Phone:714-796-8960
Mailing Address - Fax:714-828-6783
Practice Address - Street 1:7300 LA PALMA AVE BLDG 6
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90620-2623
Practice Address - Country:US
Practice Address - Phone:714-796-8960
Practice Address - Fax:714-828-6783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-31
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251300000XAgenciesLocal Education Agency (LEA)Group - Single Specialty