Provider Demographics
NPI:1760536072
Name:HADLEY LUZERNE CENTRAL SCHOOL DISTRICT
Entity Type:Organization
Organization Name:HADLEY LUZERNE CENTRAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:M
Authorized Official - Last Name:DEBONIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-696-2112
Mailing Address - Street 1:27 BEN ROSA PARK
Mailing Address - Street 2:
Mailing Address - City:LAKE LUZERNE
Mailing Address - State:NY
Mailing Address - Zip Code:12845-0200
Mailing Address - Country:US
Mailing Address - Phone:518-696-2112
Mailing Address - Fax:518-696-5402
Practice Address - Street 1:27 BEN ROSA PARK
Practice Address - Street 2:
Practice Address - City:LAKE LUZERNE
Practice Address - State:NY
Practice Address - Zip Code:12845-0200
Practice Address - Country:US
Practice Address - Phone:518-696-2112
Practice Address - Fax:518-696-5402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
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
NY01406871Medicaid