Provider Demographics
NPI:1982901229
Name:MASTERY CHARTER MANN ELEMENTARY SCHOOL
Entity type:Organization
Organization Name:MASTERY CHARTER MANN ELEMENTARY SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST. PRINCIPLE OF STUDENT SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:FARRUGGIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-495-2840
Mailing Address - Street 1:5376 W BERKS ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-3229
Mailing Address - Country:US
Mailing Address - Phone:215-495-2840
Mailing Address - Fax:
Practice Address - Street 1:5376 W BERKS ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-3229
Practice Address - Country:US
Practice Address - Phone:215-495-2840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-23
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)