Provider Demographics
NPI:1578625380
Name:LIGONIER VALLEY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:LIGONIER VALLEY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF STUDENT SUPPORT SERVICE
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:E
Authorized Official - Last Name:RAUCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-238-5696
Mailing Address - Street 1:339 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LIGONIER
Mailing Address - State:PA
Mailing Address - Zip Code:15658-1131
Mailing Address - Country:US
Mailing Address - Phone:724-238-5696
Mailing Address - Fax:724-238-7877
Practice Address - Street 1:339 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LIGONIER
Practice Address - State:PA
Practice Address - Zip Code:15658-1131
Practice Address - Country:US
Practice Address - Phone:724-238-5696
Practice Address - Fax:724-238-7877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
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
PA0014453860001Medicaid