Provider Demographics
NPI:1699109793
Name:MEMPHIS STREET ACADEMY CHARTER SCHOOL
Entity type:Organization
Organization Name:MEMPHIS STREET ACADEMY CHARTER SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BORELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-291-4709
Mailing Address - Street 1:2950 MEMPHIS ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19134-4314
Mailing Address - Country:US
Mailing Address - Phone:215-291-4709
Mailing Address - Fax:215-291-4754
Practice Address - Street 1:2950 MEMPHIS STREET
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134
Practice Address - Country:US
Practice Address - Phone:215-291-4709
Practice Address - Fax:215-291-4754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-26
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)