Provider Demographics
NPI:1730905654
Name:MOUNTAIN MAHOGANY COMMUNITY SCHOOL
Entity type:Organization
Organization Name:MOUNTAIN MAHOGANY COMMUNITY SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-241-9078
Mailing Address - Street 1:5014 4TH ST NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-3908
Mailing Address - Country:US
Mailing Address - Phone:505-341-1424
Mailing Address - Fax:505-341-1428
Practice Address - Street 1:5014 4TH ST NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-3908
Practice Address - Country:US
Practice Address - Phone:505-341-1424
Practice Address - Fax:505-341-1428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)