MEDICARE: MAINE SCHOOL ADMINISTRATIVE DISTRICT 19

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1831309855
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAINE SCHOOL ADMINISTRATIVE DISTRICT 19

Provider Business Mailing Address
First Line	:	44 SOUTH ST
Second Line	:
City	:	LUBEC
State	:	ME
Zip	:	04652-4002
Country	:	US
Telephone Number	:	207-733-5561
Fax Number	:	207-733-2013

Provider Business Practice Location Address
First Line	:	44 SOUTH ST
Second Line	:
City	:	LUBEC
State	:	ME
Zip	:	04652-4002
Country	:	US
Telephone Number	:	207-733-5561
Fax Number	:	207-733-2013

Authorized Official
Title or Position	:	DIRECTOR OF SPECIAL EDUCATION
Name	:	MS. JOAN M. CALLAHAN
Credential	:
Telephone Number	:	207-733-5561

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	08/22/2020

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