NPI |
1770194060 |
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No |
Entity Type Code |
2 |
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual
human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO). |
Employer Identification Number EIN |
|
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual
human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO). |
Provider Organization Name Legal Business Name |
MONROE OPERATIONS, LLC |
The name of the organization provider. If the provider is an organization, this is the legal business name. |
Provider Other Organization Name |
NEWPORT ACADEMY-PALM HILLS |
The name of the organization provider. If the provider is an organization, this is the legal business name. |
Provider Other Organization Name Type Code |
3 |
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional
name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other. |
Provider First Line Business Practice Location Address |
195 S PERALTA HILLS DR |
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional
name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other. |
Provider Business Practice Location Address City Name |
ANAHEIM |
The city name in the location address of the provider being identified. |
Provider Business Practice Location Address State Name |
CA |
The city name in the location address of the provider being identified. |
Provider Business Practice Location Address Postal Code |
928073424 |
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
Provider Business Practice Location Address Country Code If outside U S |
US |
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
Provider Business Practice Location Address Telephone Number |
7142025166 |
The telephone number associated with the location address of the provider being identified. |
Provider Enumeration Date |
8/11/2020 |
The telephone number associated with the location address of the provider being identified. |
Last Update Date |
8/23/2023 |
The date that a record was last updated or changed. |
Authorized Official Last Name |
PROCOPIO |
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider. |
Authorized Official First Name |
JOSEPH |
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider. |
Authorized Official Middle Name |
A |
The title or position of the authorized official. |
Authorized Official Title or Position |
CEO |
The title or position of the authorized official. |
Authorized Official Telephone Number |
9494324622 |
The title or position of the authorized official. |
Healthcare Provider Taxonomy Code 1 |
3245S0500X |
|
Healthcare Provider Primary Taxonomy Switch 1 |
N |
|
Healthcare Provider Taxonomy Code 2 |
323P00000X |
|
Healthcare Provider Primary Taxonomy Switch 2 |
Y |
|
Is Organization Subpart |
Y |
|
Parent Organization LBN |
MONROE CAPITAL HOLDINGS LLC |
|
Parent Organization TIN |
|
|
NPI Certification Date |
8/23/2023 |
|