Provider Demographics
NPI:1114057783
Name:CITY OF METHUEN
Entity Type:Organization
Organization Name:CITY OF METHUEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT OF SCHOOLS
Authorized Official - Prefix:DR
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITTEN
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:978-722-6001
Mailing Address - Street 1:10 DITSON PL
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-3802
Mailing Address - Country:US
Mailing Address - Phone:978-722-6001
Mailing Address - Fax:978-722-6002
Practice Address - Street 1:10 DITSON PL
Practice Address - Street 2:BOOKKEEPER, PUPIL SERVICES
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-3802
Practice Address - Country:US
Practice Address - Phone:978-722-6023
Practice Address - Fax:978-722-6025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1951114251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1951114Medicaid