Organization
ACADEMIA MODERNA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. XAVIER REYES (SCHOOL ADMINISTRATOR)
(323) 251-7123
Entity
Organization
Contact information
Practice address
2410 BROADWAY, WALNUT PARK, CA 90255-6342
(323) 251-7123
(323) 588-5354
Mailing address
2410 BROADWAY, WALNUT PARK, CA 90255-6342
(323) 251-7123
(323) 588-5354
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
0120097
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0120097
LEA
CA
01
—
19 64733 0120097
CDS CODE
CA
Enumeration date
10/07/2010
Last updated
10/07/2010
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