Provider Demographics
NPI:1891962718
Name:DR. ROBERT KETTERER CHARTER SCHOOL INC.
Entity Type:Organization
Organization Name:DR. ROBERT KETTERER CHARTER SCHOOL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOLLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-537-9110
Mailing Address - Street 1:1133 VILLAGE WAY
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-5201
Mailing Address - Country:US
Mailing Address - Phone:724-537-9110
Mailing Address - Fax:724-537-9114
Practice Address - Street 1:1133 VILLAGE WAY
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-5201
Practice Address - Country:US
Practice Address - Phone:724-537-9110
Practice Address - Fax:724-537-9114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)