Provider Demographics
NPI:1790079432
Name:CONSTELLATION SCHOOLS: PURITAS COMMUNITY ELEMENTARY
Entity type:Organization
Organization Name:CONSTELLATION SCHOOLS: PURITAS COMMUNITY ELEMENTARY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FISCAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:MASSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-515-0572
Mailing Address - Street 1:17720 PURITAS AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44135-2550
Mailing Address - Country:US
Mailing Address - Phone:216-688-0668
Mailing Address - Fax:
Practice Address - Street 1:17720 PURITAS AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44135-2550
Practice Address - Country:US
Practice Address - Phone:216-688-0680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-29
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)