Provider Demographics
NPI:1598977282
Name:CALAIS DAY TREATMENT
Entity Type:Organization
Organization Name:CALAIS DAY TREATMENT
Other - Org Name:SCHOOL UNION 106
Other - Org Type:Other Name
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:UNDERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1207-454-2821
Mailing Address - Street 1:32 BLUE DEVIL HL
Mailing Address - Street 2:
Mailing Address - City:CALAIS
Mailing Address - State:ME
Mailing Address - Zip Code:04619-4037
Mailing Address - Country:US
Mailing Address - Phone:120-745-4282
Mailing Address - Fax:120-745-4251
Practice Address - Street 1:32 BLUE DEVIL HL
Practice Address - Street 2:
Practice Address - City:CALAIS
Practice Address - State:ME
Practice Address - Zip Code:04619-4037
Practice Address - Country:US
Practice Address - Phone:120-745-4282
Practice Address - Fax:120-745-4251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME135990002Medicaid