Provider Demographics
NPI:1154450732
Name:LOYALSOCK TOWNSHIP SCHOOL DISTRICT
Entity Type:Organization
Organization Name:LOYALSOCK TOWNSHIP SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR OF SPECIAL EDUCATION
Authorized Official - Prefix:
Authorized Official - First Name:DAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-323-5326
Mailing Address - Street 1:2800 FOUR MILE DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MONTOURSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17754-9584
Mailing Address - Country:US
Mailing Address - Phone:570-232-5326
Mailing Address - Fax:570-326-2202
Practice Address - Street 1:2800 FOUR MILE DR
Practice Address - Street 2:SUITE 1
Practice Address - City:MONTOURSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17754-9584
Practice Address - Country:US
Practice Address - Phone:570-232-5326
Practice Address - Fax:570-326-2202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
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
PA0015223690002Medicaid