Provider Demographics
NPI:1730201393
Name:ERIN DUDLEY FORBES CHARTER SCHOOL
Entity type:Organization
Organization Name:ERIN DUDLEY FORBES CHARTER SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF ACADEMIC OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LENETTA
Authorized Official - Middle Name:RAYSHA
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-932-8998
Mailing Address - Street 1:225 BARNSLEY RD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19363-4102
Mailing Address - Country:US
Mailing Address - Phone:610-932-8998
Mailing Address - Fax:610-932-8798
Practice Address - Street 1:225 BARNSLEY RD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:PA
Practice Address - Zip Code:19363-4102
Practice Address - Country:US
Practice Address - Phone:610-932-8998
Practice Address - Fax:610-932-8798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
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
PA1015647190001Medicaid