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General NPI Number Information
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NPI Number | 1720470214
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Entity Type | Organization
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Legal Business Name | LIGHTHOUSE COMMUNITY CHARTER PUBLIC SCHOOL
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Dates
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Enumeration Date | 02/20/2015
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Last Update Date | 02/20/2015
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Provider Practice Location Address
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Address Line | 444 HEGENBERGER RD
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City | OAKLAND
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State | CA
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Zip | 94621-1418
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Country | US
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Telephone | 510-562-8801
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Fax | 510-271-8803
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Provider Business Mailing Address
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Address Line | 444 HEGENBERGER RD
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City | OAKLAND
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State | CA
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Zip | 94621-1418
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Country | US
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Telephone | 510-562-8801
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Fax | 510-271-8803
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Authorized Official
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Title or Position | DIRECTOR OF FINANCE
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Name | MR. BRANDON PAIGE
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Credential |
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Telephone | 510-639-8900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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