Provider Demographics
NPI:1710015540
Name:WILLIAM M. DAVIES JR, CAREER AND TECHNICAL HIGH SCHOOL
Entity Type:Organization
Organization Name:WILLIAM M. DAVIES JR, CAREER AND TECHNICAL HIGH SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-728-1500
Mailing Address - Street 1:50 JENCKES HILL RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-4602
Mailing Address - Country:US
Mailing Address - Phone:401-728-1500
Mailing Address - Fax:
Practice Address - Street 1:50 JENCKES HILL RD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-4602
Practice Address - Country:US
Practice Address - Phone:401-728-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIWD07193(I)Medicaid