Provider Demographics
NPI:1770222556
Name:THOMAS JEFFERSON CLASSICAL ACADEMY
Entity Type:Organization
Organization Name:THOMAS JEFFERSON CLASSICAL ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-657-9998
Mailing Address - Street 1:2527 US HWY 221-A
Mailing Address - Street 2:
Mailing Address - City:MOORESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28114
Mailing Address - Country:US
Mailing Address - Phone:828-657-9998
Mailing Address - Fax:
Practice Address - Street 1:1110 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043-3676
Practice Address - Country:US
Practice Address - Phone:828-245-9526
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)