MEDICARE: NORTHEASTERN EDUCATIONAL INTERMEDIATE UNIT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)		PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881642619
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHEASTERN EDUCATIONAL INTERMEDIATE UNIT

Provider Business Mailing Address
First Line	:	1200 LINE ST
Second Line	:
City	:	ARCHBALD
State	:	PA
Zip	:	18403-1918
Country	:	US
Telephone Number	:	570-876-9200
Fax Number	:	570-876-8662

Provider Business Practice Location Address
First Line	:	1200 LINE ST
Second Line	:
City	:	ARCHBALD
State	:	PA
Zip	:	18403-1918
Country	:	US
Telephone Number	:	570-876-9200
Fax Number	:	570-876-8662

Authorized Official
Title or Position	:	DIRECTOR OF SPECIAL EDUCATION
Name	:	DR. CLARENCE R LAMANNA
Credential	:	ED.D.
Telephone Number	:	570-876-9200

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	08/22/2020

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Directions to “NORTHEASTERN EDUCATIONAL INTERMEDIATE UNIT ” Practice Location

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