Provider Demographics
NPI:1528280179
Name:MAINE EDUCATIONAL CENTER FOR THE DEAF AND HARD OF HEARING
Entity type:Organization
Organization Name:MAINE EDUCATIONAL CENTER FOR THE DEAF AND HARD OF HEARING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-781-3165
Mailing Address - Street 1:1 MACWORTH ISLAND
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-0000
Mailing Address - Country:US
Mailing Address - Phone:207-781-3165
Mailing Address - Fax:207-781-6296
Practice Address - Street 1:1 MACKWORTH IS
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1900
Practice Address - Country:US
Practice Address - Phone:207-781-3165
Practice Address - Fax:207-781-6296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME17548000Medicaid