Provider Demographics
NPI:1730392531
Name:SEDGWICK SCHOOL DEPARTMENT
Entity type:Organization
Organization Name:SEDGWICK SCHOOL DEPARTMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:DSS
Authorized Official - Phone:207-359-8400
Mailing Address - Street 1:9 CATERPILLAR HILL RD
Mailing Address - Street 2:
Mailing Address - City:SARGENTVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04673-2463
Mailing Address - Country:US
Mailing Address - Phone:207-359-8400
Mailing Address - Fax:207-359-8451
Practice Address - Street 1:9 CATERPILLAR HILL RD
Practice Address - Street 2:
Practice Address - City:SARGENTVILLE
Practice Address - State:ME
Practice Address - Zip Code:04673-2463
Practice Address - Country:US
Practice Address - Phone:207-359-8400
Practice Address - Fax:207-359-8451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME251300000X251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME137190000Medicaid