Provider Demographics
NPI:1306527387
Name:PROVIDENT CHARTER SCHOOL WEST
Entity type:Organization
Organization Name:PROVIDENT CHARTER SCHOOL WEST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONAL COMPLIANCE OFFICE
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:412-709-5160
Mailing Address - Street 1:1400 TROY HILL RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-5124
Mailing Address - Country:US
Mailing Address - Phone:412-709-5160
Mailing Address - Fax:
Practice Address - Street 1:200 QUIGLEY DR
Practice Address - Street 2:
Practice Address - City:BADEN
Practice Address - State:PA
Practice Address - Zip Code:15005-1216
Practice Address - Country:US
Practice Address - Phone:412-709-5160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)