Provider Demographics
NPI:1255383303
Name:HARRISBURG CITY SCHOOL DISTRICT
Entity type:Organization
Organization Name:HARRISBURG CITY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR OF ACCESS PROGRAM
Authorized Official - Prefix:MS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:R
Authorized Official - Last Name:CUFF
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:717-703-4098
Mailing Address - Street 1:2101 N FRONT ST
Mailing Address - Street 2:BUILDING II
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-1086
Mailing Address - Country:US
Mailing Address - Phone:717-703-4098
Mailing Address - Fax:717-703-4028
Practice Address - Street 1:2101 N FRONT ST
Practice Address - Street 2:BUILDING II
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-1086
Practice Address - Country:US
Practice Address - Phone:717-703-4098
Practice Address - Fax:717-703-4028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
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
PA1001373120004Medicaid