Organization Name: | FOX LAKE GRADE SCHOOL DISTRICT #114 |
NPI Number: | 1306117304 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | THERESE A HAY (BUSINESS MANAGER) |
Mailing Address: | 29067 W Grass Lake Rd Spring Grove |
State: | IL US |
Postal Code: | 600819494 |
Phone Number: | 8479734028 |
Fax Number: | 8479734010 |
NPI Enumeration Date: | 01/23/2012 |
NPI Last Update Date: | 01/23/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QS1000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Student Health |
Taxonomy Definition: |