Provider Demographics
NPI:1437226073
Name:ROYER-GREAVES SCHOOL FOR BLIND
Entity Type:Organization
Organization Name:ROYER-GREAVES SCHOOL FOR BLIND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:T
Authorized Official - Last Name:DALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-644-1810
Mailing Address - Street 1:118 S VALLEY RD
Mailing Address - Street 2:PO BOX 1007
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1444
Mailing Address - Country:US
Mailing Address - Phone:484-237-5091
Mailing Address - Fax:484-237-5167
Practice Address - Street 1:118 S VALLEY RD
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1444
Practice Address - Country:US
Practice Address - Phone:484-237-5091
Practice Address - Fax:484-237-5167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
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
PA1000035420001Medicaid