Provider Demographics
NPI:1871700831
Name:TOWN OF CHINA
Entity type:Organization
Organization Name:TOWN OF CHINA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL EDUCATION
Authorized Official - Prefix:MS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:D'ALESSANDRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-445-1250
Mailing Address - Street 1:773 LAKEVIEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:CHINA
Mailing Address - State:ME
Mailing Address - Zip Code:04358
Mailing Address - Country:US
Mailing Address - Phone:207-445-1250
Mailing Address - Fax:207-445-3278
Practice Address - Street 1:773 LAKEVIEW DRIVE
Practice Address - Street 2:
Practice Address - City:CHINA
Practice Address - State:ME
Practice Address - Zip Code:04358
Practice Address - Country:US
Practice Address - Phone:207-445-1250
Practice Address - Fax:207-445-3278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME136350000251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME136350000Medicaid