Provider Demographics
NPI:1891996492
Name:SENECA HIGHLANDS INTERMEDIATE UNIT 9
Entity Type:Organization
Organization Name:SENECA HIGHLANDS INTERMEDIATE UNIT 9
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL EDUCATION
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:MANCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-887-5512
Mailing Address - Street 1:119 S MECHANIC ST
Mailing Address - Street 2:
Mailing Address - City:SMETHPORT
Mailing Address - State:PA
Mailing Address - Zip Code:16749-1270
Mailing Address - Country:US
Mailing Address - Phone:814-887-5512
Mailing Address - Fax:814-887-2203
Practice Address - Street 1:65 E VALLEY RD
Practice Address - Street 2:
Practice Address - City:SMETHPORT
Practice Address - State:PA
Practice Address - Zip Code:16749-4757
Practice Address - Country:US
Practice Address - Phone:814-887-9287
Practice Address - Fax:814-887-9927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014858190003Medicaid