Organization
M.S.A.D. #61
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA HANSON (DIRECTOR OF SPECIAL SERVICES)
(207) 627-4578
Entity
Organization
Contact information
Practice address
877 POLAND SPRING RD., CASCO, ME 04015
(207) 627-4578
Mailing address
877 POLAND SPRING RD., CASCO, ME 04015
(207) 627-4578
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103970001
—
ME
Enumeration date
05/08/2007
Last updated
08/13/2008
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