Provider Demographics
NPI:1942700489
Name:MARIA MONTESSORI CHARTER ACADEMY
Entity Type:Organization
Organization Name:MARIA MONTESSORI CHARTER ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:BOOTHBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-630-1510
Mailing Address - Street 1:1850 WILDCAT BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-5471
Mailing Address - Country:US
Mailing Address - Phone:916-630-1510
Mailing Address - Fax:916-624-7305
Practice Address - Street 1:1850 WILDCAT BLVD
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-5471
Practice Address - Country:US
Practice Address - Phone:916-630-1510
Practice Address - Fax:916-624-7305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)