Provider Demographics
NPI:1588861090
Name:MONMOUTH REGIONAL HIGH SCHOOL
Entity type:Organization
Organization Name:MONMOUTH REGIONAL HIGH SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:DEIDRE
Authorized Official - Middle Name:MAUREEN
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:MA,MSED,LDTC
Authorized Official - Phone:732-542-1170
Mailing Address - Street 1:1 NORMAN J FIELD WAY
Mailing Address - Street 2:
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-4005
Mailing Address - Country:US
Mailing Address - Phone:732-542-1170
Mailing Address - Fax:732-542-5677
Practice Address - Street 1:1 NORMAN J FIELD WAY
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07724-4005
Practice Address - Country:US
Practice Address - Phone:732-542-1170
Practice Address - Fax:732-542-5677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)