Provider Demographics
NPI:1982737045
Name:TOWN OF FAIRHAVEN
Entity Type:Organization
Organization Name:TOWN OF FAIRHAVEN
Other - Org Name:FAIRHAVEN PUBLIC SCHOOLS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:N
Authorized Official - Last Name:BALDWIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-979-4000
Mailing Address - Street 1:198 SPRING ST
Mailing Address - Street 2:MICHAEL LALIBERTE
Mailing Address - City:ROCKLAND
Mailing Address - State:MA
Mailing Address - Zip Code:02370-2649
Mailing Address - Country:US
Mailing Address - Phone:781-878-6056
Mailing Address - Fax:
Practice Address - Street 1:128 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:FAIRHAVEN
Practice Address - State:MA
Practice Address - Zip Code:02719-4037
Practice Address - Country:US
Practice Address - Phone:508-979-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
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
MA1950207Medicaid