1609016062 NPI number — LINCOLN PARK PERFORMING ARTS CHARTER SCHOOL

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609016062 NPI number — LINCOLN PARK PERFORMING ARTS CHARTER SCHOOL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LINCOLN PARK PERFORMING ARTS CHARTER SCHOOL
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609016062
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/25/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1706 SAW GRASS CT
Provider Second Line Business Mailing Address:
C/O WHITE MANAGEMENT INC
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15237-1466
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-366-0535
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 LINCOLN PARK
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIDLAND
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15059-1535
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-366-0535
Provider Business Practice Location Address Fax Number:
724-643-0769
Provider Enumeration Date:
02/25/2009

Additional Information

Authorized Official

Authorized Official Last Name:
POLING
Authorized Official First Name:
PATRICK
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PRINCIPAL
Authorized Official Telephone Number:
724-643-9004

Provider Taxonomy Codes

  • Taxonomy code: 251300000X , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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