Provider Demographics
NPI:1548303407
Name:DESERT SANDS UNIFIED SCHOOL DISTRICT
Entity type:Organization
Organization Name:DESERT SANDS UNIFIED SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MAA COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BENTON
Authorized Official - Middle Name:DORMAN
Authorized Official - Last Name:PALUMBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-771-8790
Mailing Address - Street 1:47950 DUNE PALMS RD
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-4000
Mailing Address - Country:US
Mailing Address - Phone:760-771-8652
Mailing Address - Fax:760-711-8659
Practice Address - Street 1:47950 DUNE PALMS RD
Practice Address - Street 2:
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-4000
Practice Address - Country:US
Practice Address - Phone:760-771-8652
Practice Address - Fax:760-711-8659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASS3367058Medicaid