Provider Demographics
NPI:1609116177
Name:JEFFERSON TOWNSHIP PUBLIC SCHOOLS
Entity Type:Organization
Organization Name:JEFFERSON TOWNSHIP PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAGGETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-663-5782
Mailing Address - Street 1:31 STATE ROUTE 181
Mailing Address - Street 2:
Mailing Address - City:LAKE HOPATCONG
Mailing Address - State:NJ
Mailing Address - Zip Code:07849-1378
Mailing Address - Country:US
Mailing Address - Phone:973-663-5782
Mailing Address - Fax:
Practice Address - Street 1:31 STATE ROUTE 181
Practice Address - Street 2:
Practice Address - City:LAKE HOPATCONG
Practice Address - State:NJ
Practice Address - Zip Code:07849-1378
Practice Address - Country:US
Practice Address - Phone:973-663-5782
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-21
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6902707Medicaid