Provider Demographics
NPI:1790005544
Name:HIGHLAND PRE-SCHOOL
Entity type:Organization
Organization Name:HIGHLAND PRE-SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TAMI
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-862-3351
Mailing Address - Street 1:29 KENNEBEC RD
Mailing Address - Street 2:
Mailing Address - City:HAMPDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04444-1315
Mailing Address - Country:US
Mailing Address - Phone:207-862-3351
Mailing Address - Fax:207-862-3351
Practice Address - Street 1:29 KENNEBEC RD
Practice Address - Street 2:
Practice Address - City:HAMPDEN
Practice Address - State:ME
Practice Address - Zip Code:04444-1315
Practice Address - Country:US
Practice Address - Phone:207-862-3351
Practice Address - Fax:207-862-3351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME213554252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEVC1000036387OtherMAINECARE
ME113670000Medicaid