Provider Demographics
NPI:1003029893
Name:SAD 29
Entity Type:Organization
Organization Name:SAD 29
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPED ADMIN ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:JERRY
Authorized Official - Last Name:MOREY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:207-528-3884
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:7 BIRD STREET
Mailing Address - City:HOULTON
Mailing Address - State:ME
Mailing Address - Zip Code:04730-0190
Mailing Address - Country:US
Mailing Address - Phone:207-532-6555
Mailing Address - Fax:207-532-6481
Practice Address - Street 1:7 BIRD ST
Practice Address - Street 2:
Practice Address - City:HOULTON
Practice Address - State:ME
Practice Address - Zip Code:04730-2402
Practice Address - Country:US
Practice Address - Phone:207-532-6555
Practice Address - Fax:207-532-6481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME103250000Medicaid