Provider Demographics
NPI:1528191947
Name:MATCH CHARTER PUBLIC HIGH SCHOOL
Entity Type:Organization
Organization Name:MATCH CHARTER PUBLIC HIGH SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:PG
Authorized Official - Last Name:SAFRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-232-0300
Mailing Address - Street 1:1001 COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-1308
Mailing Address - Country:US
Mailing Address - Phone:617-232-0300
Mailing Address - Fax:617-232-2838
Practice Address - Street 1:1001 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-1308
Practice Address - Country:US
Practice Address - Phone:617-232-0300
Practice Address - Fax:617-232-2838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)