Healthcare Provider Details
I. General information
NPI: 1023226792
Provider Name (Legal Business Name): TOWN OF WINSLOW
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/18/2007
Last Update Date: 08/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
55 BENTON AVENUE
WINSLOW ME
04901
US
IV. Provider business mailing address
55 BENTON AVENUE
WINSLOW ME
04901
US
V. Phone/Fax
- Phone: 207-859-2313
- Fax: 207-859-2325
- Phone: 207-859-2313
- Fax: 207-859-2325
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251C00000X |
| Taxonomy | Developmentally Disabled Services Day Training Agency |
| License Number | 137500002 |
| License Number State | ME |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
DEBRAJEAN
SCHEIBEL
Title or Position: SPECIAL EDUCATION DIRECTOR
Credential:
Phone: 207-859-2313