Provider Demographics
NPI:1952354433
Name:LEECHBURG AREA SCHOOL DISTRICT
Entity Type:Organization
Organization Name:LEECHBURG AREA SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL PROGRAMS COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:A
Authorized Official - Last Name:KRULUTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-845-7731
Mailing Address - Street 1:200 SIBERIAN AVE
Mailing Address - Street 2:
Mailing Address - City:LEECHBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15656-1278
Mailing Address - Country:US
Mailing Address - Phone:724-845-7731
Mailing Address - Fax:724-845-9723
Practice Address - Street 1:200 SIBERIAN AVE
Practice Address - Street 2:
Practice Address - City:LEECHBURG
Practice Address - State:PA
Practice Address - Zip Code:15656-1278
Practice Address - Country:US
Practice Address - Phone:724-845-7731
Practice Address - Fax:724-845-9723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
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
PA0014451800001Medicaid