Provider Demographics
NPI:1073123444
Name:SANTA ROSA ACADEMY, INC
Entity Type:Organization
Organization Name:SANTA ROSA ACADEMY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:TASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-672-2400
Mailing Address - Street 1:27587 LA PIEDRA RD
Mailing Address - Street 2:
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92584-8376
Mailing Address - Country:US
Mailing Address - Phone:951-672-2400
Mailing Address - Fax:951-672-6060
Practice Address - Street 1:27587 LA PIEDRA RD
Practice Address - Street 2:
Practice Address - City:MENIFEE
Practice Address - State:CA
Practice Address - Zip Code:92584-8376
Practice Address - Country:US
Practice Address - Phone:951-672-2400
Practice Address - Fax:951-672-6060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-31
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)