Provider Demographics
NPI:1992862882
Name:NORTHERN ADIRONDACK CENTRAL SCHOOL
Entity Type:Organization
Organization Name:NORTHERN ADIRONDACK CENTRAL SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-594-3986
Mailing Address - Street 1:PO BOX 164
Mailing Address - Street 2:
Mailing Address - City:ELLENBURG DEPOT
Mailing Address - State:NY
Mailing Address - Zip Code:12935-0164
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5572 STATE ROUTE 11
Practice Address - Street 2:
Practice Address - City:ELLENBURG DEPOT
Practice Address - State:NY
Practice Address - Zip Code:12935-0164
Practice Address - Country:US
Practice Address - Phone:518-594-3986
Practice Address - Fax:
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
NY01448686Medicaid