Provider Demographics
NPI:1487182689
Name:OTIS SCHOOL DEPARTMENT
Entity Type:Organization
Organization Name:OTIS SCHOOL DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:BRETTSCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:207-537-2203
Mailing Address - Street 1:105 OTIS ROAD
Mailing Address - Street 2:BEECH HILL SCHOOL
Mailing Address - City:OTIS
Mailing Address - State:ME
Mailing Address - Zip Code:04605
Mailing Address - Country:US
Mailing Address - Phone:207-537-2203
Mailing Address - Fax:207-537-3127
Practice Address - Street 1:105 OTIS RD
Practice Address - Street 2:
Practice Address - City:OTIS
Practice Address - State:ME
Practice Address - Zip Code:04605-6703
Practice Address - Country:US
Practice Address - Phone:207-537-2203
Practice Address - Fax:207-537-3127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty