Provider Demographics
NPI:1912023664
Name:CITY OF MARLBOROUGH
Entity Type:Organization
Organization Name:CITY OF MARLBOROUGH
Other - Org Name:MARLBOROUGH PUBLIC SCHOOLS
Other - Org Type:Other Name
Authorized Official - Title/Position:MAYOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:E
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-460-3770
Mailing Address - Street 1:17 WASHINGTON ST
Mailing Address - Street 2:DISTRICT EDUCATION CENTER
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-2225
Mailing Address - Country:US
Mailing Address - Phone:508-460-3509
Mailing Address - Fax:508-485-1142
Practice Address - Street 1:17 WASHINGTON ST
Practice Address - Street 2:DISTRICT EDUCATION CENTER
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-2225
Practice Address - Country:US
Practice Address - Phone:508-460-3509
Practice Address - Fax:508-485-1142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
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
MA1950711Medicaid