Organization
SHAWNEE ACADEMY. LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALDO CAVALLI (PRESIDENT)
(570) 420-8601
Entity
Organization
Contact information
Practice address
1RIVER ROAD, MINISINK HILLS, PA 18341
(570) 420-8601
(570) 420-0613
Mailing address
PO BOX 338, SHAWNEE ON DELAWARE, PA 18356-0338
(570) 420-8601
(570) 420-0613
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
1721
NJ
323P00000X
Psychiatric Residential Treatment Facility
213140
PA
323P00000X
Psychiatric Residential Treatment Facility
Primary
213150
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0018252
MEDICAL ASSISTANCE
NJ
01
—
1008956910001
MEDICAL ASSISTANCE, MCO
PA
01
—
119491
CBH
PA
Enumeration date
10/31/2006
Last updated
08/22/2020
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