Provider Demographics
NPI:1770790875
Name:LEBANON TOWNSHIP SCHOOL DISTRICT
Entity type:Organization
Organization Name:LEBANON TOWNSHIP SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR OF SPECIAL SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGE
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-832-2174
Mailing Address - Street 1:70 BUNNVALE RD
Mailing Address - Street 2:
Mailing Address - City:CALIFON
Mailing Address - State:NJ
Mailing Address - Zip Code:07830-5101
Mailing Address - Country:US
Mailing Address - Phone:908-638-4521
Mailing Address - Fax:908-638-5511
Practice Address - Street 1:400 ROUTE 513
Practice Address - Street 2:
Practice Address - City:CALIFON
Practice Address - State:NJ
Practice Address - Zip Code:07830
Practice Address - Country:US
Practice Address - Phone:908-638-2175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========Medicaid