Provider Demographics
NPI:1093842106
Name:CANASERAGA CENTRAL SCHOOL
Entity Type:Organization
Organization Name:CANASERAGA CENTRAL SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:GROFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-545-6421
Mailing Address - Street 1:PO BOX 230
Mailing Address - Street 2:
Mailing Address - City:CANASERAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14822-0230
Mailing Address - Country:US
Mailing Address - Phone:607-545-6421
Mailing Address - Fax:607-545-6265
Practice Address - Street 1:4 MAIN ST
Practice Address - Street 2:
Practice Address - City:CANASERAGA
Practice Address - State:NY
Practice Address - Zip Code:14822-0230
Practice Address - Country:US
Practice Address - Phone:607-545-6421
Practice Address - Fax:607-545-6265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01379226Medicare ID - Type Unspecified