Provider Demographics
NPI:1396863692
Name:NEW MILFORD PUBLIC SCHOOL
Entity Type:Organization
Organization Name:NEW MILFORD PUBLIC SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR OF SPECIAL EDUCATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADELE
Authorized Official - Middle Name:S
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-354-2654
Mailing Address - Street 1:50 EAST ST
Mailing Address - Street 2:OFFICE OF STUDENT AFFAIRS
Mailing Address - City:NEW MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06776-3030
Mailing Address - Country:US
Mailing Address - Phone:860-354-2654
Mailing Address - Fax:860-210-2682
Practice Address - Street 1:25 SUNNY VALLEY RD
Practice Address - Street 2:SARAH NOBLE INTERMEDIATE SCHOOL
Practice Address - City:NEW MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06776-3333
Practice Address - Country:US
Practice Address - Phone:860-210-4020
Practice Address - Fax:860-210-4030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2011-05-09
Deactivation Date:2008-06-03
Deactivation Code:
Reactivation Date:2011-05-09
Provider Licenses
StateLicense IDTaxonomies
CT251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004097657Medicaid