Provider Demographics
NPI:1871708248
Name:CITY OF LEWISTON SCHOOL DEPARTMENT
Entity type:Organization
Organization Name:CITY OF LEWISTON SCHOOL DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SALTZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-795-4100
Mailing Address - Street 1:36 OAK ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7149
Mailing Address - Country:US
Mailing Address - Phone:207-795-4100
Mailing Address - Fax:207-795-4177
Practice Address - Street 1:36 OAK ST
Practice Address - Street 2:DINGLEY BUILDING
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7149
Practice Address - Country:US
Practice Address - Phone:207-795-4100
Practice Address - Fax:207-795-4177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME120480001Medicaid
ME120480000Medicaid
METCM-120480100Medicaid