Provider Demographics
NPI:1578728994
Name:THURGOOD MARSHALL ACADEMY PCHS
Entity Type:Organization
Organization Name:THURGOOD MARSHALL ACADEMY PCHS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACADEMIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-563-6862
Mailing Address - Street 1:2427 MARTIN LUTHER KING JR AVE SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-5815
Mailing Address - Country:US
Mailing Address - Phone:202-563-6862
Mailing Address - Fax:202-563-6946
Practice Address - Street 1:2427 MARTIN LUTHER KING JR AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-5815
Practice Address - Country:US
Practice Address - Phone:202-563-6862
Practice Address - Fax:202-563-6946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-24
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCE-02-7441251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)