Provider Demographics
NPI:1740452937
Name:HACKETTSTOWN SCHOOL DISTRICT
Entity type:Organization
Organization Name:HACKETTSTOWN SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:CONKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-850-6523
Mailing Address - Street 1:PO BOX 465
Mailing Address - Street 2:315 WASHINGTON STREET
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-0465
Mailing Address - Country:US
Mailing Address - Phone:908-850-6500
Mailing Address - Fax:
Practice Address - Street 1:315 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-2235
Practice Address - Country:US
Practice Address - Phone:908-850-6500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0151637Medicaid