Provider Demographics
NPI:1144377284
Name:PALISADES SCHOOL DISTRICT
Entity Type:Organization
Organization Name:PALISADES SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PUPIL SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:M
Authorized Official - Last Name:GLADFELTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-847-5131
Mailing Address - Street 1:39 THOMAS FREE DR
Mailing Address - Street 2:
Mailing Address - City:KINTNERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18930-9657
Mailing Address - Country:US
Mailing Address - Phone:610-847-5131
Mailing Address - Fax:610-847-8116
Practice Address - Street 1:39 THOMAS FREE DR
Practice Address - Street 2:
Practice Address - City:KINTNERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18930-9657
Practice Address - Country:US
Practice Address - Phone:610-847-5131
Practice Address - Fax:610-847-8116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
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
PA1013322690001Medicaid