Healthcare Provider Details

I. General information

NPI: 1639382310
Provider Name (Legal Business Name): MSAD 6
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94 MAIN ST
BUXTON ME
04093
US

IV. Provider business mailing address

PO BOX 38
BAR MILLS ME
04004-0038
US

V. Phone/Fax

Practice location:
  • Phone: 207-929-9105
  • Fax: 207-929-5955
Mailing address:
  • Phone: 207-929-9105
  • Fax: 207-929-5955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: PHILLIP J POTENZIANO
Title or Position: SPECIAL ED CO-DIRECTOR
Credential:
Phone: 207-929-9105