Healthcare Provider Details

I. General information

NPI: 1770790875
Provider Name (Legal Business Name): LEBANON TOWNSHIP SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 ROUTE 513
CALIFON NJ
07830
US

IV. Provider business mailing address

70 BUNNVALE RD
CALIFON NJ
07830-5101
US

V. Phone/Fax

Practice location:
  • Phone: 908-638-2175
  • Fax:
Mailing address:
  • Phone: 908-638-4521
  • Fax: 908-638-5511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number StateNJ

VIII. Authorized Official

Name: MRS. MARGE MEYER
Title or Position: SUPERVISOR OF SPECIAL SERVICES
Credential:
Phone: 908-832-2174