Provider Demographics
NPI:1609905124
Name:SCHUYLKILL VALLEY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:SCHUYLKILL VALLEY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL EDUCATION AND P
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:LACEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-916-5745
Mailing Address - Street 1:929 LAKESHORE DRIVE
Mailing Address - Street 2:
Mailing Address - City:LEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:19533-8629
Mailing Address - Country:US
Mailing Address - Phone:610-916-5745
Mailing Address - Fax:610-916-4503
Practice Address - Street 1:929 LAKESHORE DRIVE
Practice Address - Street 2:
Practice Address - City:LEESPORT
Practice Address - State:PA
Practice Address - Zip Code:19533-8629
Practice Address - Country:US
Practice Address - Phone:610-916-5745
Practice Address - Fax:610-916-4503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018705310001Medicaid