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.