Provider Demographics
NPI:1770222606
Name:STATESMEN COLLEGE PREPARATORY ACADEMY FOR BOYS
Entity Type:Organization
Organization Name:STATESMEN COLLEGE PREPARATORY ACADEMY FOR BOYS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR OF STUDENT SUPPORT
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEI
Authorized Official - Middle Name:
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-830-2310
Mailing Address - Street 1:4600 LIVINGSTON RD SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-3136
Mailing Address - Country:US
Mailing Address - Phone:202-832-2310
Mailing Address - Fax:
Practice Address - Street 1:4600 LIVINGSTON RD SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-3136
Practice Address - Country:US
Practice Address - Phone:202-832-2310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)