Provider Demographics
NPI:1811362031
Name:BAYSTATE ACADEMY CHARTER PUBLIC SCHOOL
Entity Type:Organization
Organization Name:BAYSTATE ACADEMY CHARTER PUBLIC SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:SNEED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-366-5100
Mailing Address - Street 1:174 BRUSH HILL AVE
Mailing Address - Street 2:
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-1204
Mailing Address - Country:US
Mailing Address - Phone:413-735-2200
Mailing Address - Fax:413-735-2270
Practice Address - Street 1:2001 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-1657
Practice Address - Country:US
Practice Address - Phone:413-366-5100
Practice Address - Fax:413-366-5101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-14
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)