Provider Demographics
NPI:1477592491
Name:VALLEY GROVE SCHOOL DISTRICT
Entity Type:Organization
Organization Name:VALLEY GROVE SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR OF STUDENT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:AYLESWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:814-432-4919
Mailing Address - Street 1:429 WILEY AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:PA
Mailing Address - Zip Code:16323-2834
Mailing Address - Country:US
Mailing Address - Phone:814-432-4919
Mailing Address - Fax:
Practice Address - Street 1:429 WILEY AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:PA
Practice Address - Zip Code:16323-2834
Practice Address - Country:US
Practice Address - Phone:814-432-4919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-05
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
PA0012935510001Medicaid