Provider Demographics
NPI:1740606102
Name:CORRALES INTERNATIONAL CHARTER SCHOOL
Entity Type:Organization
Organization Name:CORRALES INTERNATIONAL CHARTER SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELSY
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-344-9733
Mailing Address - Street 1:3821 SINGER BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-5804
Mailing Address - Country:US
Mailing Address - Phone:505-344-9733
Mailing Address - Fax:
Practice Address - Street 1:3821 SINGER BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-5804
Practice Address - Country:US
Practice Address - Phone:505-344-9733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-10
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM028251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1598842973OtherNPI
NM1063846863OtherNPI
NM1518191352OtherNPI
NM1538591334OtherNPI