Provider Demographics
NPI:1578778320
Name:BEACON CHARTER HIGH SCHOOL FOR THE ARTS
Entity Type:Organization
Organization Name:BEACON CHARTER HIGH SCHOOL FOR THE ARTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:PILKINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MAT
Authorized Official - Phone:401-671-6261
Mailing Address - Street 1:320 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-3138
Mailing Address - Country:US
Mailing Address - Phone:401-671-6261
Mailing Address - Fax:401-671-6264
Practice Address - Street 1:320 MAIN ST
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-3138
Practice Address - Country:US
Practice Address - Phone:401-671-6261
Practice Address - Fax:401-671-6264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIBC59496Medicaid