Provider Demographics
NPI:1750610150
Name:OTIS SCHOOL DEPARTMENT
Entity type:Organization
Organization Name:OTIS SCHOOL DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPT. OF SCHOOLS
Authorized Official - Prefix:MR
Authorized Official - First Name:RAY
Authorized Official - Middle Name:
Authorized Official - Last Name:FREVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-537-2203
Mailing Address - Street 1:248 STATE ST STE 3A
Mailing Address - Street 2:
Mailing Address - City:ELLSWORTH
Mailing Address - State:ME
Mailing Address - Zip Code:04605-1850
Mailing Address - Country:US
Mailing Address - Phone:207-537-2203
Mailing Address - Fax:207-667-6493
Practice Address - Street 1:248 STATE ST STE 3A
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-1850
Practice Address - Country:US
Practice Address - Phone:207-537-2203
Practice Address - Fax:207-667-6493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-14
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)