Provider Demographics
NPI:1669686341
Name:CAPE ELIZABETH SCHOOL DEPARTMENT
Entity Type:Organization
Organization Name:CAPE ELIZABETH SCHOOL DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF INSTRUCTIONAL SUPPORT
Authorized Official - Prefix:MR
Authorized Official - First Name:DOMINIC
Authorized Official - Middle Name:A
Authorized Official - Last Name:DEPATSY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-799-3987
Mailing Address - Street 1:320 OCEAN HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:CAPE ELIZABETH
Mailing Address - State:ME
Mailing Address - Zip Code:04107-2419
Mailing Address - Country:US
Mailing Address - Phone:207-799-3987
Mailing Address - Fax:
Practice Address - Street 1:320 OCEAN HOUSE RD
Practice Address - Street 2:
Practice Address - City:CAPE ELIZABETH
Practice Address - State:ME
Practice Address - Zip Code:04107-2419
Practice Address - Country:US
Practice Address - Phone:207-799-3987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME=========Medicaid