Provider Demographics
NPI:1932165933
Name:CANON-MCMILLAN SCHOOL DISTRICT
Entity Type:Organization
Organization Name:CANON-MCMILLAN SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION COORDINATOR/LEA
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:W
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-746-9414
Mailing Address - Street 1:25 E COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-1321
Mailing Address - Country:US
Mailing Address - Phone:724-873-5231
Mailing Address - Fax:724-746-9604
Practice Address - Street 1:25 E COLLEGE ST
Practice Address - Street 2:
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-1321
Practice Address - Country:US
Practice Address - Phone:724-873-5231
Practice Address - Fax:724-746-9604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
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
PA0015487030001Medicaid