Provider Demographics
NPI:1497511430
Name:ALTUS SCHOOLS SOUTHERN CALIFORNIA
Entity Type:Organization
Organization Name:ALTUS SCHOOLS SOUTHERN CALIFORNIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR OF SPECIAL EDUCATION
Authorized Official - Prefix:
Authorized Official - First Name:KIRSTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-393-2270
Mailing Address - Street 1:10170 HUENNEKENS ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-2964
Mailing Address - Country:US
Mailing Address - Phone:858-678-2020
Mailing Address - Fax:
Practice Address - Street 1:111 FLETCHER PKWY
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-2510
Practice Address - Country:US
Practice Address - Phone:858-678-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)