Organization
MSAD 25
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN A DOE (SUPERINTENDENT OF SCHOOLS)
(207) 365-4272
Entity
Organization
Contact information
Practice address
805 STATION ROAD, STACYVILLE, ME 04777
(207) 365-4272
Mailing address
805 STATION ROAD, STACYVILLE, ME 04777
(207) 365-4272
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1031900001
—
ME
Enumeration date
05/03/2007
Last updated
08/22/2020
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