Provider Demographics
NPI:1720206295
Name:BURLINGTON COUNTY SPECIAL SERVICES SCHOOL DISTRICT
Entity Type:Organization
Organization Name:BURLINGTON COUNTY SPECIAL SERVICES SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:W
Authorized Official - Last Name:DONNELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-261-5600
Mailing Address - Street 1:20 PIONEER BLVD
Mailing Address - Street 2:
Mailing Address - City:WESTAMPTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-3824
Mailing Address - Country:US
Mailing Address - Phone:609-261-5600
Mailing Address - Fax:609-261-2177
Practice Address - Street 1:20 PIONEER BLVD
Practice Address - Street 2:
Practice Address - City:WESTAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08060-3824
Practice Address - Country:US
Practice Address - Phone:609-261-5600
Practice Address - Fax:609-261-2177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6505007Medicaid