Provider Demographics
NPI:1225366289
Name:TOWN OF KITTERY
Entity Type:Organization
Organization Name:TOWN OF KITTERY
Other - Org Name:KITTERY SCHOOL DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:SPECIAL SERVICES ADMINISTRATIVE AST
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-475-1331
Mailing Address - Street 1:200 ROGERS RD
Mailing Address - Street 2:
Mailing Address - City:KITTERY
Mailing Address - State:ME
Mailing Address - Zip Code:03904-1458
Mailing Address - Country:US
Mailing Address - Phone:207-475-1331
Mailing Address - Fax:
Practice Address - Street 1:200 ROGERS RD
Practice Address - Street 2:
Practice Address - City:KITTERY
Practice Address - State:ME
Practice Address - Zip Code:03904-1458
Practice Address - Country:US
Practice Address - Phone:207-475-1331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-02
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME112200001OtherMAINECARE - DAY TREATMENT SERVICES
ME1225366289Medicaid
ME112200000OtherMAINECARE - SCHOOL BASED REHABILITATIVE SERVICES