Provider Demographics
NPI:1497884068
Name:NORTHWEST AREA SCHOOL DISTRICT
Entity Type:Organization
Organization Name:NORTHWEST AREA SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR OF SPECIAL EDUCATION
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:M
Authorized Official - Last Name:SORBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-256-3649
Mailing Address - Street 1:21 SUNSET LAKE RD
Mailing Address - Street 2:
Mailing Address - City:SHICKSHINNY
Mailing Address - State:PA
Mailing Address - Zip Code:18655-4326
Mailing Address - Country:US
Mailing Address - Phone:570-256-7300
Mailing Address - Fax:
Practice Address - Street 1:21 SUNSET LAKE RD
Practice Address - Street 2:
Practice Address - City:SHICKSHINNY
Practice Address - State:PA
Practice Address - Zip Code:18655-4326
Practice Address - Country:US
Practice Address - Phone:570-256-7300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015117400001Medicaid