Provider Demographics
NPI:1588003693
Name:JUSTIN SIENA HIGH SCHOOL
Entity Type:Organization
Organization Name:JUSTIN SIENA HIGH SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:MANZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-255-1855
Mailing Address - Street 1:2310 1ST ST
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-2239
Mailing Address - Country:US
Mailing Address - Phone:707-255-1855
Mailing Address - Fax:707-255-5621
Practice Address - Street 1:2310 1ST ST
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-2239
Practice Address - Country:US
Practice Address - Phone:707-255-1855
Practice Address - Fax:707-255-5621
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOYD WOLFE JUVENILE JUSTICE NETWORK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-06-21
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)