Provider Demographics
NPI:1508986399
Name:GROTON-DUNSTABLE REGIONAL SCHOOL DISTRICT
Entity Type:Organization
Organization Name:GROTON-DUNSTABLE REGIONAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PUPIL PERSONNEL SERVICE
Authorized Official - Prefix:MS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ENDICOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-448-5505
Mailing Address - Street 1:PO BOX 729
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:MA
Mailing Address - Zip Code:01450-0729
Mailing Address - Country:US
Mailing Address - Phone:978-448-5505
Mailing Address - Fax:978-448-1202
Practice Address - Street 1:73 PEPPERELL RD
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:MA
Practice Address - Zip Code:01450-0729
Practice Address - Country:US
Practice Address - Phone:978-448-5505
Practice Address - Fax:978-448-1202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1952315Medicaid