Provider Demographics
NPI:1962763342
Name:BRIDGE BOSTON CHARTER SCHOOL
Entity type:Organization
Organization Name:BRIDGE BOSTON CHARTER SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JUG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOKSHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:857-229-1601
Mailing Address - Street 1:633 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-2526
Mailing Address - Country:US
Mailing Address - Phone:857-229-1601
Mailing Address - Fax:
Practice Address - Street 1:633 CENTRE ST
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-2526
Practice Address - Country:US
Practice Address - Phone:857-229-1601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-02
Last Update Date:2012-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0417251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)