Provider Demographics
NPI:1841333796
Name:GOVERNOR MOREHEAD SCHOOL FOR THE BLIND
Entity type:Organization
Organization Name:GOVERNOR MOREHEAD SCHOOL FOR THE BLIND
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-855-4430
Mailing Address - Street 1:MSC 2302
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27699-0001
Mailing Address - Country:US
Mailing Address - Phone:919-855-4430
Mailing Address - Fax:919-733-2970
Practice Address - Street 1:303 ASHE AVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-2102
Practice Address - Country:US
Practice Address - Phone:919-855-4430
Practice Address - Fax:919-733-2970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8600045Medicaid