Provider Demographics
NPI:1609127406
Name:INGENIUM CHARTER SCHOOL
Entity Type:Organization
Organization Name:INGENIUM CHARTER SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:SOELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-456-4590
Mailing Address - Street 1:22250 ELKWOOD ST
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91304-5501
Mailing Address - Country:US
Mailing Address - Phone:818-456-4590
Mailing Address - Fax:818-835-9594
Practice Address - Street 1:22250 ELKWOOD ST
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91304-5501
Practice Address - Country:US
Practice Address - Phone:818-456-4590
Practice Address - Fax:818-835-9594
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INGENIUM SCHOOLS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-09-20
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19766790121137251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)