Provider Demographics
NPI:1043594450
Name:GILLINGHAM CHARTER SCHOOL
Entity Type:Organization
Organization Name:GILLINGHAM CHARTER SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF ORGANIZATIONAL DEVELOP
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:WERKHEISER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, NCC
Authorized Official - Phone:570-955-3830
Mailing Address - Street 1:912 HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:POTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17901-3422
Mailing Address - Country:US
Mailing Address - Phone:570-955-3830
Mailing Address - Fax:570-955-3831
Practice Address - Street 1:912 HOWARD AVE
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-3422
Practice Address - Country:US
Practice Address - Phone:570-955-3830
Practice Address - Fax:570-955-3831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-04
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)