Provider Demographics
NPI:1992835466
Name:TOWN OF PROVINCETOWN
Entity Type:Organization
Organization Name:TOWN OF PROVINCETOWN
Other - Org Name:PROVINCETOWN PUBLIC SCHOOLS
Other - Org Type:Other Name
Authorized Official - Title/Position:SUPERINTENDENT OF SCHOOLS
Authorized Official - Prefix:MS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:WAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-487-5000
Mailing Address - Street 1:2 MAYFLOWER LN
Mailing Address - Street 2:
Mailing Address - City:PROVINCETOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02657-1441
Mailing Address - Country:US
Mailing Address - Phone:508-487-5000
Mailing Address - Fax:508-487-5000
Practice Address - Street 1:2 MAYFLOWER LN
Practice Address - Street 2:
Practice Address - City:PROVINCETOWN
Practice Address - State:MA
Practice Address - Zip Code:02657-1441
Practice Address - Country:US
Practice Address - Phone:508-487-5000
Practice Address - Fax:508-487-5000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
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
MA1953893Medicaid