Provider Demographics
NPI:1346429180
Name:SCHOOL DISTRICT OF BELLEVILLE
Entity Type:Organization
Organization Name:SCHOOL DISTRICT OF BELLEVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF STUDENT SERVICES
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-424-1902
Mailing Address - Street 1:635 W CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53508-9361
Mailing Address - Country:US
Mailing Address - Phone:608-424-1902
Mailing Address - Fax:608-424-3692
Practice Address - Street 1:635 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:WI
Practice Address - Zip Code:53508-9361
Practice Address - Country:US
Practice Address - Phone:608-424-1902
Practice Address - Fax:608-424-3692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44224600Medicaid