Provider Demographics
NPI:1033233275
Name:KENOSHA UNIFIED SCHOOL DISTRICT NO. 1
Entity Type:Organization
Organization Name:KENOSHA UNIFIED SCHOOL DISTRICT NO. 1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:L
Authorized Official - Last Name:JOHNSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-653-6172
Mailing Address - Street 1:3600 52ND ST
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53144-2664
Mailing Address - Country:US
Mailing Address - Phone:262-653-6300
Mailing Address - Fax:262-653-7753
Practice Address - Street 1:3600 52ND ST
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53144-2664
Practice Address - Country:US
Practice Address - Phone:262-653-6300
Practice Address - Fax:262-653-7753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44202800Medicaid
WI67279300Medicaid