Healthcare Provider Details

I. General information

NPI: 1538301353
Provider Name (Legal Business Name): MSAD 75
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2009
Last Update Date: 03/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 REPUBLIC AVE
TOPSHAM ME
04086-1136
US

IV. Provider business mailing address

50 REPUBLIC AVE
TOPSHAM ME
04086-1136
US

V. Phone/Fax

Practice location:
  • Phone: 207-729-1557
  • Fax: 207-725-9354
Mailing address:
  • Phone: 207-729-1557
  • Fax: 207-725-9354

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: BETH JOHNSON
Title or Position: SPED ADMINISTRATIVE ASSISTANT
Credential:
Phone: 207-729-1557