Provider Demographics
NPI:1699980441
Name:SMITHFIELD SCHOOL DEPARTMENT
Entity type:Organization
Organization Name:SMITHFIELD SCHOOL DEPARTMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL EDUCATION
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:401-231-6608
Mailing Address - Street 1:49 FARNUM PIKE
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02917-3211
Mailing Address - Country:US
Mailing Address - Phone:401-231-6608
Mailing Address - Fax:401-232-1580
Practice Address - Street 1:49 FARNUM PIKE
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:RI
Practice Address - Zip Code:02917-3211
Practice Address - Country:US
Practice Address - Phone:401-231-6608
Practice Address - Fax:401-232-1580
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOWN OR SMITHFIELD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
RISS00805Medicaid