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General NPI Number Information
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NPI Number | 1871830265
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Entity Type | Organization
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Legal Business Name | MASTERY CHARTER CLEVELAND ELEMENTARY
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Dates
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Enumeration Date | 01/07/2013
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Last Update Date | 01/07/2013
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Provider Practice Location Address
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Address Line | 3701 N 19TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19140-3555
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Country | US
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Telephone | 215-227-5042
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Fax |
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Provider Business Mailing Address
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Address Line | 5700 WAYNE AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19144-3314
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ACCESS COORDINATOR
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Name | MONICA BROWN
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Credential |
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Telephone | 215-866-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number | 102732757
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License Number State | PA
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