Provider Demographics
NPI:1578510590
Name:PENNCREST SCHOOL DISTRICT
Entity Type:Organization
Organization Name:PENNCREST SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ASTOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-337-1626
Mailing Address - Street 1:18741 STATE HWY 198
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAEGERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:16433-4315
Mailing Address - Country:US
Mailing Address - Phone:814-337-1626
Mailing Address - Fax:814-763-5129
Practice Address - Street 1:18741 STATE HWY 198
Practice Address - Street 2:SUITE 101
Practice Address - City:SAEGERTOWN
Practice Address - State:PA
Practice Address - Zip Code:16433-4315
Practice Address - Country:US
Practice Address - Phone:814-337-1626
Practice Address - Fax:814-763-5129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
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
PA1001341790004Medicaid