Organization
PROSPECT HILL ACADEMY CHARTER SCHOOL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JED FRANK LIPPARD (HEAD OF SCHOOL)
(617) 284-7800
Entity
Organization
Contact information
Practice address
15 WEBSTER AVE, SOMERVILLE, MA 02143-3311
(617) 284-7800
Mailing address
15 WEBSTER AVE, SOMERVILLE, MA 02143-3311
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1956035
MASSHEALTH PROVIDER NUM.
MA
Enumeration date
03/22/2007
Last updated
08/22/2020
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