Provider Demographics
NPI:1831307495
Name:LAKEWOOD BOARD OF EDUCATION
Entity Type:Organization
Organization Name:LAKEWOOD BOARD OF EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TOBIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-905-3541
Mailing Address - Street 1:655 PRINCETON AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-2882
Mailing Address - Country:US
Mailing Address - Phone:732-905-3542
Mailing Address - Fax:732-905-3638
Practice Address - Street 1:655 PRINCETON AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-2882
Practice Address - Country:US
Practice Address - Phone:732-905-3542
Practice Address - Fax:732-905-3638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
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
NJ6705901Medicaid