Provider Demographics
NPI:1407106602
Name:MISSION ACHIEVEMENT AND SUCCESS CHARTER SCHOOL
Entity Type:Organization
Organization Name:MISSION ACHIEVEMENT AND SUCCESS CHARTER SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:M
Authorized Official - Last Name:PENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-242-3118
Mailing Address - Street 1:1718 YALE BLVD SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4286
Mailing Address - Country:US
Mailing Address - Phone:505-242-3118
Mailing Address - Fax:505-242-3062
Practice Address - Street 1:1718 YALE BLVD SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-4286
Practice Address - Country:US
Practice Address - Phone:505-242-3118
Practice Address - Fax:505-242-3062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)