Provider Demographics
NPI:1124233226
Name:MSAD56
Entity Type:Organization
Organization Name:MSAD56
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:GOGUEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-548-2312
Mailing Address - Street 1:30 MORTLAND RD
Mailing Address - Street 2:
Mailing Address - City:SEARSPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04974-6311
Mailing Address - Country:US
Mailing Address - Phone:207-546-2312
Mailing Address - Fax:
Practice Address - Street 1:30 MORTLAND RD
Practice Address - Street 2:
Practice Address - City:SEARSPORT
Practice Address - State:ME
Practice Address - Zip Code:04974-6311
Practice Address - Country:US
Practice Address - Phone:207-546-2312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)