Provider Demographics
NPI:1013131408
Name:ELK TOWNSHIP PUBLIC SCHOOL DISTRICT
Entity Type:Organization
Organization Name:ELK TOWNSHIP PUBLIC SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHILD STUDY TEAM SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PEG
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-881-4551
Mailing Address - Street 1:100 UNIONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:GLASSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08028-3500
Mailing Address - Country:US
Mailing Address - Phone:856-881-4551
Mailing Address - Fax:856-881-3674
Practice Address - Street 1:100 UNIONVILLE RD
Practice Address - Street 2:
Practice Address - City:GLASSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08028-3500
Practice Address - Country:US
Practice Address - Phone:856-881-4551
Practice Address - Fax:856-881-3674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
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
NJ9027301Medicaid