Provider Demographics
NPI:1720960412
Name:NORTHWEST TRI-COUNTY INTERMEDIATE UNIT
Entity type:Organization
Organization Name:NORTHWEST TRI-COUNTY INTERMEDIATE UNIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPPORT SERVICES SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:POLIVKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-734-5610
Mailing Address - Street 1:252 WATERFORD ST
Mailing Address - Street 2:
Mailing Address - City:EDINBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16412-2315
Mailing Address - Country:US
Mailing Address - Phone:814-734-5610
Mailing Address - Fax:
Practice Address - Street 1:252 WATERFORD ST
Practice Address - Street 2:
Practice Address - City:EDINBORO
Practice Address - State:PA
Practice Address - Zip Code:16412-2315
Practice Address - Country:US
Practice Address - Phone:814-734-5610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHWEST TRI-COUNTY INTERMEDIATE UNIT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)