Provider Demographics
NPI:1841316601
Name:SANTA ROSA CONSOLIDATED SCHOOLS
Entity type:Organization
Organization Name:SANTA ROSA CONSOLIDATED SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-472-3171
Mailing Address - Street 1:344 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:NM
Mailing Address - Zip Code:88435-2325
Mailing Address - Country:US
Mailing Address - Phone:505-472-3171
Mailing Address - Fax:505-472-5609
Practice Address - Street 1:344 S 4TH ST
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:NM
Practice Address - Zip Code:88435-2325
Practice Address - Country:US
Practice Address - Phone:505-472-3171
Practice Address - Fax:505-472-5609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM000L5223251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)