Provider Demographics
NPI:1033154687
Name:CHESTER COMMUNITY CHARTER SCHOOL
Entity Type:Organization
Organization Name:CHESTER COMMUNITY CHARTER SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXEC. VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GUREGHIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-447-0400
Mailing Address - Street 1:214 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19013-4510
Mailing Address - Country:US
Mailing Address - Phone:610-447-0400
Mailing Address - Fax:610-876-5716
Practice Address - Street 1:214 E 5TH ST
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-4510
Practice Address - Country:US
Practice Address - Phone:610-447-0400
Practice Address - Fax:610-876-5716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1001255270002Medicaid