Provider Demographics
NPI:1700194727
Name:FRYEBURG ACADEMY
Entity Type:Organization
Organization Name:FRYEBURG ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAYNSFORD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:207-935-2318
Mailing Address - Street 1:745 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FRYEBURG
Mailing Address - State:ME
Mailing Address - Zip Code:04037-1322
Mailing Address - Country:US
Mailing Address - Phone:207-935-2001
Mailing Address - Fax:207-935-4292
Practice Address - Street 1:745 MAIN ST
Practice Address - Street 2:
Practice Address - City:FRYEBURG
Practice Address - State:ME
Practice Address - Zip Code:04037-1322
Practice Address - Country:US
Practice Address - Phone:207-935-2001
Practice Address - Fax:207-935-4292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-24
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPRIVATE SCHOOL251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)