Provider Demographics
NPI:1760504393
Name:ANNVILLE-CLEONA SCHOOL DISTRICT
Entity Type:Organization
Organization Name:ANNVILLE-CLEONA SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR OF SPECIAL EDUCATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:SETLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:717-867-7603
Mailing Address - Street 1:520 S WHITE OAK ST
Mailing Address - Street 2:
Mailing Address - City:ANNVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17003-2200
Mailing Address - Country:US
Mailing Address - Phone:717-867-7603
Mailing Address - Fax:717-867-7610
Practice Address - Street 1:520 S WHITE OAK ST
Practice Address - Street 2:
Practice Address - City:ANNVILLE
Practice Address - State:PA
Practice Address - Zip Code:17003-2200
Practice Address - Country:US
Practice Address - Phone:717-867-7603
Practice Address - Fax:717-867-7610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1010416280001Medicaid