Provider Demographics
NPI:1174679591
Name:SALMON RIVER CENTRAL SCHOOL
Entity Type:Organization
Organization Name:SALMON RIVER CENTRAL SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PUPIL PERSONNEL SERVICE
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-358-6630
Mailing Address - Street 1:637 COUNTY ROUTE 1
Mailing Address - Street 2:
Mailing Address - City:FORT COVINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:12937-2807
Mailing Address - Country:US
Mailing Address - Phone:518-358-6630
Mailing Address - Fax:518-358-9776
Practice Address - Street 1:637 COUNTY ROUTE 1
Practice Address - Street 2:
Practice Address - City:FORT COVINGTON
Practice Address - State:NY
Practice Address - Zip Code:12937-2807
Practice Address - Country:US
Practice Address - Phone:518-358-6630
Practice Address - Fax:518-358-9776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
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
NY01510301Medicaid