Provider Demographics
NPI:1851507982
Name:SCHOOL ADMIN DISTRICT NO. 57
Entity Type:Organization
Organization Name:SCHOOL ADMIN DISTRICT NO. 57
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT OF SCHOOLS
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERBURNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-247-3221
Mailing Address - Street 1:86 WEST RD
Mailing Address - Street 2:
Mailing Address - City:WATERBORO
Mailing Address - State:ME
Mailing Address - Zip Code:04087-3209
Mailing Address - Country:US
Mailing Address - Phone:207-247-3221
Mailing Address - Fax:
Practice Address - Street 1:86 WEST RD
Practice Address - Street 2:
Practice Address - City:WATERBORO
Practice Address - State:ME
Practice Address - Zip Code:04087-3209
Practice Address - Country:US
Practice Address - Phone:207-247-3221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1038200001Medicaid