Healthcare Provider Details

I. General information

NPI: 1114984143
Provider Name (Legal Business Name): CLARION AREA SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 BOUNDARY ST
CLARION PA
16214-1655
US

IV. Provider business mailing address

800 BOUNDARY ST
CLARION PA
16214-1655
US

V. Phone/Fax

Practice location:
  • Phone: 814-226-8118
  • Fax: 814-226-9292
Mailing address:
  • Phone: 814-226-8118
  • Fax: 814-226-9292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0014768290001
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name: MS. ROSE A BALOUGH
Title or Position: BUSINESS MANAGER
Credential:
Phone: 814-226-6110