Provider Demographics
NPI:1396862413
Name:CLINTON PUBLIC SCHOOLS
Entity Type:Organization
Organization Name:CLINTON PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT OF SCHOOLS
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:GAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-365-4200
Mailing Address - Street 1:150 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01510-2915
Mailing Address - Country:US
Mailing Address - Phone:978-365-4220
Mailing Address - Fax:978-365-5037
Practice Address - Street 1:150 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MA
Practice Address - Zip Code:01510-2915
Practice Address - Country:US
Practice Address - Phone:978-365-4220
Practice Address - Fax:978-365-5037
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOWN OF CLINTON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-23
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA00640000251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1953303Medicaid