Provider Demographics
NPI:1225185457
Name:WILMAC SPECIAL EDUCATION UNIT
Entity Type:Organization
Organization Name:WILMAC SPECIAL EDUCATION UNIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-572-6757
Mailing Address - Street 1:PO BOX 2397
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:ND
Mailing Address - Zip Code:58802-2397
Mailing Address - Country:US
Mailing Address - Phone:701-572-6757
Mailing Address - Fax:701-774-3532
Practice Address - Street 1:222 UNIVERSITY AVENUE
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:ND
Practice Address - Zip Code:58801
Practice Address - Country:US
Practice Address - Phone:701-572-6757
Practice Address - Fax:701-774-3532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251300000XAgenciesLocal Education Agency (LEA)
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND000019017Medicaid
ND000019034Medicaid