Provider Demographics
NPI:1407356520
Name:JOEL BARLOW HIGH SCHOOL
Entity Type:Organization
Organization Name:JOEL BARLOW HIGH SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE & OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:A
Authorized Official - Last Name:REISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-261-6513
Mailing Address - Street 1:654 MOREHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:CT
Mailing Address - Zip Code:06612-1338
Mailing Address - Country:US
Mailing Address - Phone:203-261-6513
Mailing Address - Fax:203-261-2513
Practice Address - Street 1:100 BLACK ROCK TPKE
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CT
Practice Address - Zip Code:06896-3000
Practice Address - Country:US
Practice Address - Phone:203-938-2508
Practice Address - Fax:203-938-3281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-15
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT209251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT209OtherLOCAL EDUCATION AGENCY (LEA)