Provider Demographics
NPI:1215378757
Name:CITY ON A HILL NEW BEDFORD
Entity type:Organization
Organization Name:CITY ON A HILL NEW BEDFORD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-445-1515
Mailing Address - Street 1:58 CIRCUIT ST
Mailing Address - Street 2:
Mailing Address - City:ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02119-1925
Mailing Address - Country:US
Mailing Address - Phone:617-445-1515
Mailing Address - Fax:
Practice Address - Street 1:58 CIRCUIT ST
Practice Address - Street 2:FINAL LOCATION TO BE DETERMINED IN NEW BEDFORD
Practice Address - City:ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02119-1925
Practice Address - Country:US
Practice Address - Phone:617-445-1515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-12
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3507251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)