Provider Demographics
NPI:1902182066
Name:PORTLAND PUBLIC SCHOOLS
Entity Type:Organization
Organization Name:PORTLAND PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRAZIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-874-8225
Mailing Address - Street 1:57 DOUGLASS ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-2524
Mailing Address - Country:US
Mailing Address - Phone:207-874-8225
Mailing Address - Fax:207-874-8292
Practice Address - Street 1:57 DOUGLASS ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-2524
Practice Address - Country:US
Practice Address - Phone:207-874-8225
Practice Address - Fax:207-874-8292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-02
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC4960251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health