Provider Demographics
NPI:1215027735
Name:HARBOR CREEK SCHOOL DISTRICT
Entity Type:Organization
Organization Name:HARBOR CREEK SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:J
Authorized Official - Last Name:DOLAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-897-2100
Mailing Address - Street 1:6375 BUFFALO ROAD
Mailing Address - Street 2:
Mailing Address - City:HARBOR CREEK
Mailing Address - State:PA
Mailing Address - Zip Code:16421-1606
Mailing Address - Country:US
Mailing Address - Phone:814-897-2100
Mailing Address - Fax:814-897-2121
Practice Address - Street 1:6375 BUFFALO RD
Practice Address - Street 2:
Practice Address - City:HARBORCREEK
Practice Address - State:PA
Practice Address - Zip Code:16421-1632
Practice Address - Country:US
Practice Address - Phone:814-897-2100
Practice Address - Fax:814-897-2121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016341220001Medicaid