Organization
WINDHAM ASHLAND JEWETT CSD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE MATTICE (BUSINESS OFFICIAL)
(518) 734-4229
Entity
Organization
Contact information
Practice address
5411 STATE ROUTE 23, WINDHAM, NY 12496
(518) 734-4229
(518) 734-6050
Mailing address
P.O. BOX 429, WINDHAM, NY 12496
(518) 734-4229
(518) 734-6050
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01381960
—
NY
Enumeration date
12/22/2006
Last updated
05/07/2015
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