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General NPI Number Information
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NPI Number | 1104946896
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Entity Type | Organization
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Legal Business Name | PLYMOUTH BD OF ED
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 77 MAIN ST
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City | TERRYVILLE
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State | CT
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Zip | 06786-5104
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Country | US
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Telephone | 860-314-2768
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Fax | 860-314-2766
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Provider Business Mailing Address
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Address Line | 77 MAIN ST
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City | TERRYVILLE
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State | CT
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Zip | 06786-5104
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Country | US
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Telephone | 860-314-2768
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Fax | 860-314-2766
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MR. GERARD PERUSSE PERUSSE
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Credential |
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Telephone | 860-314-2768
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State | CT
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