Provider Demographics
NPI:1154661122
Name:LINDENWOLD BOARD OF EDUCATION
Entity Type:Organization
Organization Name:LINDENWOLD BOARD OF EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-783-0276
Mailing Address - Street 1:801 EGG HARBOR RD
Mailing Address - Street 2:
Mailing Address - City:LINDENWOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-1327
Mailing Address - Country:US
Mailing Address - Phone:856-783-0276
Mailing Address - Fax:
Practice Address - Street 1:801 EGG HARBOR RD
Practice Address - Street 2:
Practice Address - City:LINDENWOLD
Practice Address - State:NJ
Practice Address - Zip Code:08021-1327
Practice Address - Country:US
Practice Address - Phone:856-783-0276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-27
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6637205Medicaid