Provider Demographics
NPI:1689885196
Name:MAINE SCHOOL ADMINISTRATIVE DISTRICT34
Entity Type:Organization
Organization Name:MAINE SCHOOL ADMINISTRATIVE DISTRICT34
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAILLOUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-338-1960
Mailing Address - Street 1:PO BOX 363
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-0363
Mailing Address - Country:US
Mailing Address - Phone:207-338-1960
Mailing Address - Fax:207-338-4597
Practice Address - Street 1:6A LIONS WAY
Practice Address - Street 2:
Practice Address - City:BELFAST
Practice Address - State:ME
Practice Address - Zip Code:04915-6666
Practice Address - Country:US
Practice Address - Phone:207-338-1960
Practice Address - Fax:207-338-4597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services