Provider Demographics
NPI:1023141108
Name:TOWN OF ACUSHNET
Entity type:Organization
Organization Name:TOWN OF ACUSHNET
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT OF SCHOOLS
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DONOVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-998-0260
Mailing Address - Street 1:708 MIDDLE RD STE 1
Mailing Address - Street 2:
Mailing Address - City:ACUSHNET
Mailing Address - State:MA
Mailing Address - Zip Code:02743-1409
Mailing Address - Country:US
Mailing Address - Phone:508-338-0260
Mailing Address - Fax:508-998-0262
Practice Address - Street 1:708 MIDDLE RD STE 1
Practice Address - Street 2:
Practice Address - City:ACUSHNET
Practice Address - State:MA
Practice Address - Zip Code:02743-1409
Practice Address - Country:US
Practice Address - Phone:508-338-0260
Practice Address - Fax:508-998-0262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1950886Medicaid
MA1950886Medicaid