Provider Demographics
NPI:1548427834
Name:SCHUYLKILL HAVEN AREA SCHOOL DISTRICT
Entity Type:Organization
Organization Name:SCHUYLKILL HAVEN AREA SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:RADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-385-6705
Mailing Address - Street 1:120 HAVEN ST
Mailing Address - Street 2:
Mailing Address - City:SCHUYLKILL HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:17972-1199
Mailing Address - Country:US
Mailing Address - Phone:570-385-6705
Mailing Address - Fax:
Practice Address - Street 1:120 HAVEN ST
Practice Address - Street 2:
Practice Address - City:SCHUYLKILL HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17972-1110
Practice Address - Country:US
Practice Address - Phone:570-385-6705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0013944470001Medicaid