Provider Demographics
NPI:1336481282
Name:CORNVILLE REGIONAL CHARTER SCHOOL
Entity Type:Organization
Organization Name:CORNVILLE REGIONAL CHARTER SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:NATHAN
Authorized Official - Last Name:BELANGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-474-8503
Mailing Address - Street 1:1192 W RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CORNVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04976-6214
Mailing Address - Country:US
Mailing Address - Phone:207-474-8503
Mailing Address - Fax:207-474-8515
Practice Address - Street 1:1192 W RIDGE RD
Practice Address - Street 2:
Practice Address - City:CORNVILLE
Practice Address - State:ME
Practice Address - Zip Code:04976-6214
Practice Address - Country:US
Practice Address - Phone:207-474-8503
Practice Address - Fax:207-474-8515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-19
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)