Provider Demographics
NPI:1376726299
Name:SCHOOL DISTRICT OF JEFFERSON
Entity Type:Organization
Organization Name:SCHOOL DISTRICT OF JEFFERSON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BUSINESS SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:PEACHEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-675-1044
Mailing Address - Street 1:206 S TAFT AVE
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:WI
Mailing Address - Zip Code:53549-1453
Mailing Address - Country:US
Mailing Address - Phone:920-675-1000
Mailing Address - Fax:920-675-1020
Practice Address - Street 1:206 S TAFT AVE
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:WI
Practice Address - Zip Code:53549-1453
Practice Address - Country:US
Practice Address - Phone:920-675-1000
Practice Address - Fax:920-675-1020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-13
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI44210800251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)