Provider Demographics
NPI:1295783066
Name:CHESTER COUNTY INTERMEDIATE UNIT
Entity type:Organization
Organization Name:CHESTER COUNTY INTERMEDIATE UNIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:FIORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-237-5000
Mailing Address - Street 1:455 BOOT RD
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-3043
Mailing Address - Country:US
Mailing Address - Phone:484-237-5091
Mailing Address - Fax:484-237-5167
Practice Address - Street 1:455 BOOT RD
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-3043
Practice Address - Country:US
Practice Address - Phone:484-237-5091
Practice Address - Fax:484-237-5167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
PA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251300000XAgenciesLocal Education Agency (LEA)
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1003596060003Medicaid