=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124149372
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NORFOLK PUBLIC SCHOOLS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/03/2007
-----------------------------------------------------
Last Update Date | 09/17/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 232 MAIN ST H. OLIVE DAY SCHOOL
-----------------------------------------------------
City | NORFOLK
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02056-1338
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-541-5478
-----------------------------------------------------
Fax | 508-541-5482
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 232 MAIN ST H. OLIVE DAY SCHOOL
-----------------------------------------------------
City | NORFOLK
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02056-1338
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-541-5478
-----------------------------------------------------
Fax | 508-541-5482
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF STUDENT SUPPORT SERVICE
-----------------------------------------------------
Name | CAROL RICCARDI-GAHAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 508-541-5478
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251B00000X
-----------------------------------------------------
Taxonomy Name | Case Management Agency
-----------------------------------------------------
License Number | 251B00000X
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251300000X
-----------------------------------------------------
Taxonomy Name | Local Education Agency (LEA)
-----------------------------------------------------
License Number | 251300000X
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------