Provider Demographics
NPI:1871796318
Name:PIKE SCHOOL, INC
Entity type:Organization
Organization Name:PIKE SCHOOL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:T
Authorized Official - Last Name:WOLTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-353-9102
Mailing Address - Street 1:PO BOX 325
Mailing Address - Street 2:
Mailing Address - City:ORFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03777-0325
Mailing Address - Country:US
Mailing Address - Phone:603-353-9102
Mailing Address - Fax:603-353-9412
Practice Address - Street 1:2635 MOUNT MOOSILAUKE HWY
Practice Address - Street 2:
Practice Address - City:PIKE
Practice Address - State:NH
Practice Address - Zip Code:03780-5625
Practice Address - Country:US
Practice Address - Phone:603-989-3454
Practice Address - Fax:603-989-5488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30007095Medicaid