Provider Demographics
NPI:1639383409
Name:MSAD01
Entity Type:Organization
Organization Name:MSAD01
Other - Org Name:MAINE SCHOOL ADMIN. DISTRICT #1
Other - Org Type:Other Name
Authorized Official - Title/Position:SUPERINTENDENT OF SCHOOLS
Authorized Official - Prefix:DR
Authorized Official - First Name:GEHRIG
Authorized Official - Middle Name:T
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-764-4101
Mailing Address - Street 1:79 BLAKE ST STE 1
Mailing Address - Street 2:P.O. BOX 1118
Mailing Address - City:PRESQUE ISLE
Mailing Address - State:ME
Mailing Address - Zip Code:04769-2474
Mailing Address - Country:US
Mailing Address - Phone:207-764-4101
Mailing Address - Fax:207-764-4103
Practice Address - Street 1:79 BLAKE STREET
Practice Address - Street 2:SUITE #1
Practice Address - City:PRESQUE ISLE
Practice Address - State:ME
Practice Address - Zip Code:04769-2474
Practice Address - Country:US
Practice Address - Phone:207-764-4101
Practice Address - Fax:207-764-4103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)