Provider Demographics
NPI:1104209824
Name:LAKELAND REGIONAL HIGH SCHOOL
Entity Type:Organization
Organization Name:LAKELAND REGIONAL HIGH SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:COONEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-835-1900
Mailing Address - Street 1:205 CONKLINTOWN RD
Mailing Address - Street 2:
Mailing Address - City:WANAQUE
Mailing Address - State:NJ
Mailing Address - Zip Code:07465-2122
Mailing Address - Country:US
Mailing Address - Phone:973-835-1900
Mailing Address - Fax:973-835-6369
Practice Address - Street 1:205 CONKLINTOWN RD
Practice Address - Street 2:
Practice Address - City:WANAQUE
Practice Address - State:NJ
Practice Address - Zip Code:07465-2122
Practice Address - Country:US
Practice Address - Phone:973-835-1900
Practice Address - Fax:973-835-6369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)