Provider Demographics
NPI:1922058395
Name:VANGUARD SCHOOL
Entity Type:Organization
Organization Name:VANGUARD SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF EDUCATION
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:L
Authorized Official - Last Name:LANSHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-296-6700
Mailing Address - Street 1:1777 NORTH VALLEY RD
Mailing Address - Street 2:PO BOX 730
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-0730
Mailing Address - Country:US
Mailing Address - Phone:610-296-6700
Mailing Address - Fax:610-640-0132
Practice Address - Street 1:1777 NORTH VALLEY RD
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-0730
Practice Address - Country:US
Practice Address - Phone:610-296-6700
Practice Address - Fax:610-640-0132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
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
PA1007721180001Medicaid