Provider Demographics
NPI:1295865673
Name:UPPER CAPE COD RVT SCHOOL
Entity Type:Organization
Organization Name:UPPER CAPE COD RVT SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT OF SCHOOLS
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-759-7711
Mailing Address - Street 1:220 SANDWICH RD
Mailing Address - Street 2:
Mailing Address - City:BOURNE
Mailing Address - State:MA
Mailing Address - Zip Code:02532-3310
Mailing Address - Country:US
Mailing Address - Phone:508-759-7711
Mailing Address - Fax:508-759-7208
Practice Address - Street 1:220 SANDWICH RD
Practice Address - Street 2:
Practice Address - City:BOURNE
Practice Address - State:MA
Practice Address - Zip Code:02532-3310
Practice Address - Country:US
Practice Address - Phone:508-759-7711
Practice Address - Fax:508-759-7208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
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
MA1952773Medicaid