MEDICARE: BOLTON BOARD OF EDUCATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1427194539
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOLTON BOARD OF EDUCATION

Provider Business Mailing Address
First Line	:	108 NOTCH RD
Second Line	:
City	:	BOLTON
State	:	CT
Zip	:	06043-7431
Country	:	US
Telephone Number	:	860-643-1569
Fax Number	:	860-647-8452

Provider Business Practice Location Address
First Line	:	108 NOTCH RD
Second Line	:
City	:	BOLTON
State	:	CT
Zip	:	06043-7431
Country	:	US
Telephone Number	:	860-643-1569
Fax Number	:	860-647-8452

Authorized Official
Title or Position	:	DIRECTOR OF PUPIL SERVICES
Name	:	MS. KATHLEEN GOODWIN
Credential	:
Telephone Number	:	860-643-1569

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	08/22/2020

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Directions to “BOLTON BOARD OF EDUCATION ” Practice Location

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