Provider Demographics
NPI:1609098201
Name:CLARKE PENNSYLVANIA, INC.
Entity Type:Organization
Organization Name:CLARKE PENNSYLVANIA, INC.
Other - Org Name:CLARKE SCHOOLS FOR HEARING AND SPEECH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:SEXTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-385-3436
Mailing Address - Street 1:2 PENN BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-1416
Mailing Address - Country:US
Mailing Address - Phone:267-385-3436
Mailing Address - Fax:
Practice Address - Street 1:2 PENN BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-1416
Practice Address - Country:US
Practice Address - Phone:267-385-3436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA325230001251300000X
PA326510169251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1019929940004Medicaid
PA1019929940002Medicaid
PA1019929940003Medicaid