Provider Demographics
NPI:1588832877
Name:NORTHLAND PREPARATORY ACADEMY
Entity Type:Organization
Organization Name:NORTHLAND PREPARATORY ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LOMBARDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-214-8776
Mailing Address - Street 1:3300 E SPARROW AVE
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86004-6703
Mailing Address - Country:US
Mailing Address - Phone:928-214-8776
Mailing Address - Fax:
Practice Address - Street 1:3300 E SPARROW AVE
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86004-6703
Practice Address - Country:US
Practice Address - Phone:928-214-8776
Practice Address - Fax:928-214-8778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)