Provider Demographics
NPI:1922621200
Name:TIMES 2 STEM ACADEMY
Entity Type:Organization
Organization Name:TIMES 2 STEM ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:COLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:YAROSHENKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-345-0433
Mailing Address - Street 1:45 PLYMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-1837
Mailing Address - Country:US
Mailing Address - Phone:401-345-0433
Mailing Address - Fax:
Practice Address - Street 1:50 FILLMORE ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908-3105
Practice Address - Country:US
Practice Address - Phone:401-272-5094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-21
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)