Provider Demographics
NPI:1336458082
Name:ROCK CREEK COMMUNITY ACADEMY
Entity Type:Organization
Organization Name:ROCK CREEK COMMUNITY ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MIDDLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-246-9271
Mailing Address - Street 1:11525 HIGHWAY 31
Mailing Address - Street 2:
Mailing Address - City:SELLERSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47172-9618
Mailing Address - Country:US
Mailing Address - Phone:812-246-9271
Mailing Address - Fax:812-246-0722
Practice Address - Street 1:11515 HIGHWAY 31
Practice Address - Street 2:
Practice Address - City:SELLERSBURG
Practice Address - State:IN
Practice Address - Zip Code:47172-9618
Practice Address - Country:US
Practice Address - Phone:812-246-9271
Practice Address - Fax:812-246-0722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-29
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN9875251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)