Provider Demographics
NPI:1790801132
Name:GILL-MONTAGUE REGIONAL SCHOOL DISTRICT
Entity Type:Organization
Organization Name:GILL-MONTAGUE REGIONAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:ROCKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-863-9324
Mailing Address - Street 1:31 WEST ST
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-4019
Mailing Address - Country:US
Mailing Address - Phone:978-986-1785
Mailing Address - Fax:781-961-6999
Practice Address - Street 1:35 CROCKER AVE
Practice Address - Street 2:
Practice Address - City:TURNERS FALLS
Practice Address - State:MA
Practice Address - Zip Code:01376-1926
Practice Address - Country:US
Practice Address - Phone:413-863-9324
Practice Address - Fax:413-863-4560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1953273Medicaid