Provider Demographics
NPI:1689465718
Name:LIBERTAS COLLEGE PREPARATORY
Entity type:Organization
Organization Name:LIBERTAS COLLEGE PREPARATORY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF LEADERSHIP DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLSTONE HURST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-902-6808
Mailing Address - Street 1:5101 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90062-2333
Mailing Address - Country:US
Mailing Address - Phone:323-400-6149
Mailing Address - Fax:
Practice Address - Street 1:5101 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90062-2333
Practice Address - Country:US
Practice Address - Phone:323-400-6149
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)