Healthcare Provider Details

I. General information

NPI: 1689880932
Provider Name (Legal Business Name): TOWN OF WOODLAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 07/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

844 WOODLAND CENTER RD
WOODLAND ME
04736-5156
US

IV. Provider business mailing address

843 WOODLAND CENTER RD
WOODLAND ME
04736-5145
US

V. Phone/Fax

Practice location:
  • Phone: 207-496-2981
  • Fax: 207-496-6913
Mailing address:
  • Phone: 207-498-8436
  • Fax: 207-498-6349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN E HEDMAN
Title or Position: SUPERINTENDENT OF SCHOOLS
Credential:
Phone: 207-498-8436