Provider Demographics
NPI:1164626529
Name:TOWN OF MADAWASKA SCHOOL DEPARTMENT
Entity Type:Organization
Organization Name:TOWN OF MADAWASKA SCHOOL DEPARTMENT
Other - Org Name:TOWN OF MADAWASKA SCHOOL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SPECIAL EDUCATION DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CASTONGUAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-728-3371
Mailing Address - Street 1:135-7TH AVENUE
Mailing Address - Street 2:MADAWASKA SCHOOL DEPARTMENT
Mailing Address - City:MADAWASKA
Mailing Address - State:ME
Mailing Address - Zip Code:04756
Mailing Address - Country:US
Mailing Address - Phone:207-728-3371
Mailing Address - Fax:207-728-3636
Practice Address - Street 1:135 7TH AVE
Practice Address - Street 2:
Practice Address - City:MADAWASKA
Practice Address - State:ME
Practice Address - Zip Code:04756-1159
Practice Address - Country:US
Practice Address - Phone:207-728-3371
Practice Address - Fax:207-728-3636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1030260000Medicaid