Provider Demographics
NPI:1659339604
Name:CONEMAUGH TOWNSHIP AREA SCHOOL DISTRICT
Entity Type:Organization
Organization Name:CONEMAUGH TOWNSHIP AREA SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:KAKABAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-479-7575
Mailing Address - Street 1:300 W CAMPUS AVE
Mailing Address - Street 2:PO BOX 407
Mailing Address - City:DAVIDSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15928-0407
Mailing Address - Country:US
Mailing Address - Phone:814-479-7431
Mailing Address - Fax:814-479-2620
Practice Address - Street 1:300 W CAMPUS AVE
Practice Address - Street 2:
Practice Address - City:DAVIDSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15928-0407
Practice Address - Country:US
Practice Address - Phone:814-479-7431
Practice Address - Fax:814-479-2620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-01
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0013020700001Medicaid