Provider Demographics
NPI:1942642368
Name:PAULO FREIRE SOCIAL JUSTICE CHARTER SCHOOL
Entity Type:Organization
Organization Name:PAULO FREIRE SOCIAL JUSTICE CHARTER SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BOB
Authorized Official - Middle Name:
Authorized Official - Last Name:BRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-575-0084
Mailing Address - Street 1:161 LOWER WESTFIELD RD
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-2768
Mailing Address - Country:US
Mailing Address - Phone:413-575-0084
Mailing Address - Fax:
Practice Address - Street 1:161 LOWER WESTFIELD RD
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-2768
Practice Address - Country:US
Practice Address - Phone:413-575-0084
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-26
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA89Medicaid