Provider Demographics
NPI:1164723888
Name:MOUNT DESERT ISLAND REGIONAL SCHOOL DISTRCT
Entity Type:Organization
Organization Name:MOUNT DESERT ISLAND REGIONAL SCHOOL DISTRCT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGION SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EDITH
Authorized Official - Middle Name:H
Authorized Official - Last Name:DUBOIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:207-288-5011
Mailing Address - Street 1:P.O. 60
Mailing Address - Street 2:
Mailing Address - City:MT. DESERT
Mailing Address - State:ME
Mailing Address - Zip Code:04462
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1081 EAGLE LAKE RD
Practice Address - Street 2:
Practice Address - City:BAR HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04662
Practice Address - Country:US
Practice Address - Phone:207-288-9867
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-11
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC10914251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)