Healthcare Provider Details

I. General information

NPI: 1619178613
Provider Name (Legal Business Name): SCHOOL ADMINISTRATIVE DISTRICT 31
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 09/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 CROSS ST MSAD #31 CENTRAL OFFICE
HOWLAND ME
04448
US

IV. Provider business mailing address

23 CROSS ST MSAD #31 CENTRAL OFFICE
HOWLAND ME
04448
US

V. Phone/Fax

Practice location:
  • Phone: 207-732-8307
  • Fax:
Mailing address:
  • Phone: 207-732-8307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: BONNET S MCCAFFREY
Title or Position: DIRECTOR OF ED. RESOURCES
Credential:
Phone: 207-732-8307