Provider Demographics
NPI:1336364769
Name:LINCOLN INTERMEDIATE UNIT 12
Entity type:Organization
Organization Name:LINCOLN INTERMEDIATE UNIT 12
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION FISCAL MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LETTY
Authorized Official - Middle Name:C
Authorized Official - Last Name:GROFT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-624-6419
Mailing Address - Street 1:65 BILLERBECK ST
Mailing Address - Street 2:PO BOX 70
Mailing Address - City:NEW OXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:17350-9375
Mailing Address - Country:US
Mailing Address - Phone:717-624-4616
Mailing Address - Fax:717-624-6523
Practice Address - Street 1:65 BILLERBECK ST
Practice Address - Street 2:
Practice Address - City:NEW OXFORD
Practice Address - State:PA
Practice Address - Zip Code:17350-9375
Practice Address - Country:US
Practice Address - Phone:717-624-4616
Practice Address - Fax:717-624-6523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty