Provider Demographics
NPI:1346453024
Name:SCHOOL ADMINISTRATIVE DISTRICT NO 54
Entity type:Organization
Organization Name:SCHOOL ADMINISTRATIVE DISTRICT NO 54
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:MELANNIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:KEISTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-474-2497
Mailing Address - Street 1:196 W FRONT ST
Mailing Address - Street 2:
Mailing Address - City:SKOWHEGAN
Mailing Address - State:ME
Mailing Address - Zip Code:04976-5108
Mailing Address - Country:US
Mailing Address - Phone:207-474-7424
Mailing Address - Fax:
Practice Address - Street 1:196 W FRONT ST
Practice Address - Street 2:
Practice Address - City:SKOWHEGAN
Practice Address - State:ME
Practice Address - Zip Code:04976-5108
Practice Address - Country:US
Practice Address - Phone:207-474-2497
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME103800000Medicaid