Provider Demographics
NPI:1013045327
Name:SACKETS HARBOR CENTRAL SCHOOL
Entity Type:Organization
Organization Name:SACKETS HARBOR CENTRAL SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:C
Authorized Official - Last Name:SPAZIANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-646-3575
Mailing Address - Street 1:215 SOUTH BROAD STREET
Mailing Address - Street 2:
Mailing Address - City:SACKETS HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:13685
Mailing Address - Country:US
Mailing Address - Phone:315-646-3575
Mailing Address - Fax:316-646-1038
Practice Address - Street 1:215 SOUTH BROAD STREET
Practice Address - Street 2:
Practice Address - City:SACKETS HARBOR
Practice Address - State:NY
Practice Address - Zip Code:13685
Practice Address - Country:US
Practice Address - Phone:315-646-3575
Practice Address - Fax:316-646-1038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01383628Medicaid