Provider Demographics
NPI:1124464698
Name:FREEHOLD REGIONAL HIGH SCHOOL DISTRICT
Entity type:Organization
Organization Name:FREEHOLD REGIONAL HIGH SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIERCTOR OF SPECIAL SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:732-792-7300
Mailing Address - Street 1:11 PINE ST
Mailing Address - Street 2:
Mailing Address - City:ENGLISHTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-1513
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11 PINE ST
Practice Address - Street 2:
Practice Address - City:ENGLISHTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07726-1513
Practice Address - Country:US
Practice Address - Phone:732-792-7300
Practice Address - Fax:732-786-0594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-10
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0275123Medicaid