Provider Demographics
NPI:1720470214
Name:LIGHTHOUSE COMMUNITY CHARTER PUBLIC SCHOOL
Entity Type:Organization
Organization Name:LIGHTHOUSE COMMUNITY CHARTER PUBLIC SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:PAIGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-639-8900
Mailing Address - Street 1:444 HEGENBERGER RD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94621-1418
Mailing Address - Country:US
Mailing Address - Phone:510-562-8801
Mailing Address - Fax:510-271-8803
Practice Address - Street 1:444 HEGENBERGER RD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94621-1418
Practice Address - Country:US
Practice Address - Phone:510-562-8801
Practice Address - Fax:510-271-8803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-20
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)