Healthcare Provider Details

I. General information

NPI: 1215841648
Provider Name (Legal Business Name): ALTUS SCHOOLS SOUTHERN CALIFORNIA DBA ALTUS SCHOOLS MIRUS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14135 MAIN ST STE 201
HESPERIA CA
92345-8094
US

IV. Provider business mailing address

14135 MAIN ST STE 201
HESPERIA CA
92345-8094
US

V. Phone/Fax

Practice location:
  • Phone: 760-947-7100
  • Fax:
Mailing address:
  • Phone: 760-947-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number StateNULL

VIII. Authorized Official

Name: LYNNE ALIPIO
Title or Position: CHIEF BUSINESS OFFICER
Credential:
Phone: 858-678-2048