Provider Demographics
NPI:1669846952
Name:TOWN OF WORTHINGTON
Entity Type:Organization
Organization Name:TOWN OF WORTHINGTON
Other - Org Name:R.H. CONWELL SCHOOL
Other - Org Type:Other Name
Authorized Official - Title/Position:SUPERINTENDENT OF SCHOOLS
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:JURGENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:413-527-7200
Mailing Address - Street 1:147 HUNTINGTON RD
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01098-9542
Mailing Address - Country:US
Mailing Address - Phone:413-527-7200
Mailing Address - Fax:
Practice Address - Street 1:147 HUNTINGTON RD
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:MA
Practice Address - Zip Code:01098-9542
Practice Address - Country:US
Practice Address - Phone:413-527-7200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-24
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)