Provider Demographics
NPI:1851358899
Name:COLONIAL SCHOOL DISTRICT
Entity Type:Organization
Organization Name:COLONIAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PUPIL SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:K
Authorized Official - Last Name:DELONG
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:610-834-1671
Mailing Address - Street 1:230 FLOURTOWN RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-1252
Mailing Address - Country:US
Mailing Address - Phone:610-834-1671
Mailing Address - Fax:610-941-0958
Practice Address - Street 1:230 FLOURTOWN RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-1252
Practice Address - Country:US
Practice Address - Phone:610-834-1671
Practice Address - Fax:610-941-0958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
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
PA0017732420001Medicaid