Provider Demographics
NPI:1285000356
Name:PENNSYLVANIA SUPPORTS COORDINATION AGENCY
Entity Type:Organization
Organization Name:PENNSYLVANIA SUPPORTS COORDINATION AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EARLSON
Authorized Official - Middle Name:
Authorized Official - Last Name:SATINE
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:215-929-1305
Mailing Address - Street 1:218 E WISTER ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-1827
Mailing Address - Country:US
Mailing Address - Phone:215-929-1305
Mailing Address - Fax:215-843-6830
Practice Address - Street 1:218 E WISTER ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-1827
Practice Address - Country:US
Practice Address - Phone:215-929-1305
Practice Address - Fax:215-843-6830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-12
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management