Provider Demographics
NPI:1871650705
Name:BERNE-KNOX-WESTERLO CSD
Entity Type:Organization
Organization Name:BERNE-KNOX-WESTERLO CSD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT SUPERINTENDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:LABELLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-872-0945
Mailing Address - Street 1:1738 HELDERBERG TRL
Mailing Address - Street 2:
Mailing Address - City:BERNE
Mailing Address - State:NY
Mailing Address - Zip Code:12023-2926
Mailing Address - Country:US
Mailing Address - Phone:518-872-0945
Mailing Address - Fax:518-872-2031
Practice Address - Street 1:1738 HELDERBERG TRL
Practice Address - Street 2:
Practice Address - City:BERNE
Practice Address - State:NY
Practice Address - Zip Code:12023-2926
Practice Address - Country:US
Practice Address - Phone:518-872-0945
Practice Address - Fax:518-872-2031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
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
NY01384909Medicaid