Provider Demographics
NPI:1639211063
Name:HIGHLANDER CHARTER SCHOOL
Entity Type:Organization
Organization Name:HIGHLANDER CHARTER SCHOOL
Other - Org Name:SCHOOL DISTRICT
Other - Org Type:Other Name
Authorized Official - Title/Position:SPECIAL ED DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSE MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:401-277-2600
Mailing Address - Street 1:42 LEXINGTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02907-1716
Mailing Address - Country:US
Mailing Address - Phone:401-277-2600
Mailing Address - Fax:401-277-2603
Practice Address - Street 1:42 LEXINGTON AVE.
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02907-1716
Practice Address - Country:US
Practice Address - Phone:401-277-2600
Practice Address - Fax:401-277-2603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
RICV46621Medicaid