Provider Demographics
NPI:1801177589
Name:BROADMOOR CHARTER SCHOOL BOARD
Entity type:Organization
Organization Name:BROADMOOR CHARTER SCHOOL BOARD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DARIUS
Authorized Official - Middle Name:A
Authorized Official - Last Name:MUNCHAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-373-6274
Mailing Address - Street 1:3617 GENERAL PERSHING ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70125-4530
Mailing Address - Country:US
Mailing Address - Phone:504-373-6274
Mailing Address - Fax:
Practice Address - Street 1:3617 GENERAL PERSHING ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70125-4530
Practice Address - Country:US
Practice Address - Phone:504-373-6274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)