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NORTHWAY ACADEMY INC. NPI 1104333715


NPI Information

NPI: 1104333715
Provider Name: NORTHWAY ACADEMY, INC.

Former Legal Business Name: REM CENTRAL LAKES, INC. NORTHWAY ACADEMY

Classification: Clinic/Center - 261QD1600X
Entity Type: Organization

Specialization: Developmental Disabilities

Address:
108 DOCTORS PARK
SAINT CLOUD, MN
ZIP 56303
Phone: (320) 259-6022
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NORTHWAY ACADEMY, INC. is a developmental disabilities clinic center in Saint Cloud, MN. The provider is an entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.). NORTHWAY ACADEMY, INC. NPI is 1104333715. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Rem Central Lakes, Inc. Northway Academy.

The provider's business location address is:

108 DOCTORS PARK
SAINT CLOUD, MN
ZIP 56303-207
Phone: (320) 259-6022
Fax: (952) 922-6885

The provider's authorized official is Mary Patricia Rodenberg-roberts .
The authorized official title is Vice Pres & Sr. Asst Gc and has the following contact phone number (952) 836-2234.

The enumeration date for this NPI number is 1/4/2018 and was last updated on 1/23/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251S00000XCommunity/Behavioral HealthNo
2261QD1600XClinic/CenterDevelopmental DisabilitiesYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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