Provider Demographics
NPI:1639299019
Name:TOWN OF WESTBOROUGH
Entity Type:Organization
Organization Name:TOWN OF WESTBOROUGH
Other - Org Name:WESTBOROUGH PUBLIC SCHOOLS
Other - Org Type:Other Name
Authorized Official - Title/Position:ASSISTANT SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LES
Authorized Official - Middle Name:E
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-836-7702
Mailing Address - Street 1:45 W MAIN ST
Mailing Address - Street 2:P O BOX 1152
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-1916
Mailing Address - Country:US
Mailing Address - Phone:508-836-7702
Mailing Address - Fax:508-836-7704
Practice Address - Street 1:45 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-1916
Practice Address - Country:US
Practice Address - Phone:508-836-7702
Practice Address - Fax:508-836-7704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1951246251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1951246Medicaid