Provider Demographics
NPI:1194232983
Name:STATE OF CT REGIONAL HS DIST 5
Entity type:Organization
Organization Name:STATE OF CT REGIONAL HS DIST 5
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE & ADMIN
Authorized Official - Prefix:MS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-397-4813
Mailing Address - Street 1:25 NEWTON RD OFC
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CT
Mailing Address - Zip Code:06525-1521
Mailing Address - Country:US
Mailing Address - Phone:203-397-4813
Mailing Address - Fax:203-397-4864
Practice Address - Street 1:25 NEWTON RD OFC
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:CT
Practice Address - Zip Code:06525-1521
Practice Address - Country:US
Practice Address - Phone:203-397-4813
Practice Address - Fax:203-397-4864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)