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General NPI Number Information
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NPI Number | 1790665917
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Entity Type | Organization
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Legal Business Name | NORTHWAY ACADEMY, INC.
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Dates
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Enumeration Date | 09/08/2025
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 14000 NORTHDALE BLVD
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City | ROGERS
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State | MN
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Zip | 55374-4662
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Country | US
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Telephone | 763-328-2782
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Fax | 763-328-2782
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Provider Business Mailing Address
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Address Line | 6600 FRANCE AVE S STE 350
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City | EDINA
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State | MN
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Zip | 55435-1810
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Country | US
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Telephone | 800-388-5150
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Fax | 952-922-6885
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Authorized Official
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Title or Position | VP & SR ASST GENERAL COUNSEL
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Name | MARY PATRICIA RODENBERG-ROBERTS
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Credential |
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Telephone | 952-836-2234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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