NORTHWAY ACADEMY INC. NPI 1912645516

NPI Information

  • NPI: 1912645516
  • Provider Name: NORTHWAY ACADEMY, INC.
  • Classification: Clinic/Center - 261QD1600X
  • Specialization: Developmental Disabilities
  • Entity Type: Organization
  • Other Name: NORTHWAY ACADEMY, INC. ST. MICHAEL
  • Address: 12070 43RD ST NE
    SAINT MICHAEL, MN
    ZIP 55376
  • Phone: (952) 563-2207

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NPI Details

NORTHWAY ACADEMY, INC. is a developmental disabilities clinic center in Saint Michael, MN. The provider is an entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.). NORTHWAY ACADEMY, INC. NPI is 1912645516. The provider is registered as an organization entity type.
The provider Other Name Is Northway Academy, Inc. St. Michael.

The provider's business location address is:

12070 43RD ST NE
SAINT MICHAEL, MN
ZIP 55376-427
Phone: (952) 563-2207
Fax: (952) 922-6885

The provider's authorized official is Mary Patricia Rodenberg-roberts .
The authorized official title is Vp & Sr Asst Gc and has the following contact phone number (952) 836-2234.

The enumeration date for this NPI number is 5/24/2022 and was last updated on 1/23/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QD1600XClinic/CenterDevelopmental DisabilitiesYes

What is NPI?

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This page was last updated on: 11/21/2025

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