Provider Demographics
NPI:1689951899
Name:DISCOVERY CHARTER SCHOOL
Entity Type:Organization
Organization Name:DISCOVERY CHARTER SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUELYN
Authorized Official - Middle Name:Y
Authorized Official - Last Name:KELLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-879-8182
Mailing Address - Street 1:5070 PARKSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-4747
Mailing Address - Country:US
Mailing Address - Phone:215-879-8182
Mailing Address - Fax:215-879-9510
Practice Address - Street 1:5070 PARKSIDE AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-4747
Practice Address - Country:US
Practice Address - Phone:215-879-8182
Practice Address - Fax:215-879-9510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-16
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)