Provider Demographics
NPI:1386781987
Name:BERLIN CENTRAL SCHOOL DISTRICT
Entity type:Organization
Organization Name:BERLIN CENTRAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PUPIL PERSONNEL SERVICE
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:L
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-658-2515
Mailing Address - Street 1:PO BOX 259
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:NY
Mailing Address - Zip Code:12022-0259
Mailing Address - Country:US
Mailing Address - Phone:518-658-2515
Mailing Address - Fax:518-658-2012
Practice Address - Street 1:17400 NY 22
Practice Address - Street 2:
Practice Address - City:CHERRY PLAIN
Practice Address - State:NY
Practice Address - Zip Code:12040
Practice Address - Country:US
Practice Address - Phone:518-658-2515
Practice Address - Fax:518-658-2012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01379111Medicaid