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General NPI Number Information
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NPI Number | 1174851018
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Entity Type | Organization
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Legal Business Name | BLUE SCHOOL INC.
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Dates
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Enumeration Date | 12/04/2009
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Last Update Date | 06/18/2013
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Provider Practice Location Address
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Address Line | 1000 STATE STREET
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City | BANGOR
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State | ME
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Zip | 04401
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Country | US
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Telephone | 207-945-9995
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 STATE ST
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City | BANGOR
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State | ME
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Zip | 04401-5614
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KEN PALMER
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Credential |
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Telephone | 207-945-9995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State | ME
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