Healthcare Provider Details

I. General information

NPI: 1912247446
Provider Name (Legal Business Name): GLOUCESTER COUNTY SPECIAL SERVICES SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2013
Last Update Date: 08/21/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1340 TANYARD RD
SEWELL NJ
08080-4220
US

IV. Provider business mailing address

1340 TANYARD RD
SEWELL NJ
08080-4220
US

V. Phone/Fax

Practice location:
  • Phone: 856-468-1445
  • Fax:
Mailing address:
  • Phone: 856-468-1445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KATHLEEN MONTI
Title or Position: DIRECTOR OF DESS
Credential:
Phone: 856-912-5476