| Old Town School Dept. | |
|
21 Jefferson St Old Town ME 04468-2106 | |
| (207) 827-4441 | |
| (207) 827-4449 |
| Full Name | Old Town School Dept. |
|---|---|
| Speciality | Day Training, Developmentally Disabled Services |
| Location | 21 Jefferson St, Old Town, Maine |
| Authorized Official Name and Position | Anne Marie Boucher (INTERIM DIRECTOR) |
| Authorized Official Contact | 2078274441 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Old Town School Dept. P.o. Box 543 21 Jefferson Street Old Town ME 04468-0543 Ph: (207) 827-4441 | Old Town School Dept. 21 Jefferson St Old Town ME 04468-2106 Ph: (207) 827-4441 |
| NPI Number | 1316166580 |
|---|---|
| Provider Enumeration Date | 04/25/2007 |
| Last Update Date | 08/21/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316166580 | NPI | - | NPPES |
| 136030002 | Medicaid | ME |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 251C00000X | Day Training, Developmentally Disabled Services | (* (Not Available)) | Primary |