Provider Demographics
NPI:1013256304
Name:CLEARVIEW REGIONAL HIGH SCHOOL
Entity Type:Organization
Organization Name:CLEARVIEW REGIONAL HIGH SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL BUSINESS ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:R
Authorized Official - Last Name:PENNELL
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:856-223-2762
Mailing Address - Street 1:420 CEDAR RD
Mailing Address - Street 2:
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-2520
Mailing Address - Country:US
Mailing Address - Phone:856-223-2762
Mailing Address - Fax:856-478-0409
Practice Address - Street 1:420 CEDAR RD
Practice Address - Street 2:
Practice Address - City:MULLICA HILL
Practice Address - State:NJ
Practice Address - Zip Code:08062-2520
Practice Address - Country:US
Practice Address - Phone:856-223-2762
Practice Address - Fax:856-478-0409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-06
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0154181Medicaid