1932509429 NPI number — OUTSIDE IN SCHOOL OF EXPERIENTIAL EDUCATION, INC.

Table of content: (NPI 1932509429)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932509429 NPI number — OUTSIDE IN SCHOOL OF EXPERIENTIAL EDUCATION, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OUTSIDE IN SCHOOL OF EXPERIENTIAL EDUCATION, INC.
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:
1932509429
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/08/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
196 HAMILL SCHOOL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOLIVAR
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15923-2525
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-238-8441
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
150 W BEAU ST
Provider Second Line Business Practice Location Address:
SUITE 114
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15301-4425
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-837-1518
Provider Business Practice Location Address Fax Number:
724-837-0801
Provider Enumeration Date:
09/03/2014

Additional Information

Authorized Official

Authorized Official Last Name:
CAMERON
Authorized Official First Name:
ADRIEN
Authorized Official Middle Name:
Authorized Official Title or Position:
FINANCIAL TECHNICIAN MANAGER
Authorized Official Telephone Number:
724-238-8441

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X , with the licence number:  637040 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3245S0500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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