Provider Demographics
NPI:1922128727
Name:LAWRENCE FAMILY DEVELOPMENT CHARTER SCHOOL
Entity Type:Organization
Organization Name:LAWRENCE FAMILY DEVELOPMENT CHARTER SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR SUPERINTENDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:FOLEY
Authorized Official - Last Name:KARL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-689-9863
Mailing Address - Street 1:34 WEST ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01841-3426
Mailing Address - Country:US
Mailing Address - Phone:978-689-9863
Mailing Address - Fax:978-689-8133
Practice Address - Street 1:34 WEST ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-3426
Practice Address - Country:US
Practice Address - Phone:978-689-9863
Practice Address - Fax:978-689-8133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
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
MA1956027Medicaid