Provider Demographics
NPI:1578776258
Name:MAINE SCHOOL ADMINISTRATIVE DISTRICT #24
Entity Type:Organization
Organization Name:MAINE SCHOOL ADMINISTRATIVE DISTRICT #24
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT OF SCHOOL
Authorized Official - Prefix:
Authorized Official - First Name:CLAYTON
Authorized Official - Middle Name:
Authorized Official - Last Name:BELANGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-868-2746
Mailing Address - Street 1:169 MAIN ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:VAN BUREN
Mailing Address - State:ME
Mailing Address - Zip Code:04785-1249
Mailing Address - Country:US
Mailing Address - Phone:207-868-2746
Mailing Address - Fax:207-868-5420
Practice Address - Street 1:169 MAIN ST
Practice Address - Street 2:SUITE 101
Practice Address - City:VAN BUREN
Practice Address - State:ME
Practice Address - Zip Code:04785-1249
Practice Address - Country:US
Practice Address - Phone:207-868-2746
Practice Address - Fax:207-868-5420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME10311001Medicaid