Provider Demographics
NPI:1790832343
Name:CANTON CENTRAL SCHOOL DISTRICT
Entity Type:Organization
Organization Name:CANTON CENTRAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-386-8561
Mailing Address - Street 1:99 STATE ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:NY
Mailing Address - Zip Code:13617-1058
Mailing Address - Country:US
Mailing Address - Phone:315-386-8561
Mailing Address - Fax:315-386-4907
Practice Address - Street 1:99 STATE ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:NY
Practice Address - Zip Code:13617-1058
Practice Address - Country:US
Practice Address - Phone:315-386-8561
Practice Address - Fax:315-386-4907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
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
NY01379244Medicaid