Provider Demographics
NPI:1427381011
Name:GALESVILLE-ETTRICK-TREMPEALEAU SCHOOL DISTRICT
Entity Type:Organization
Organization Name:GALESVILLE-ETTRICK-TREMPEALEAU SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR OR SPECIAL EDUCATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:R
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:608-534-6391
Mailing Address - Street 1:24231 4TH ST
Mailing Address - Street 2:PO BOX 277
Mailing Address - City:TREMPEALEAU
Mailing Address - State:WI
Mailing Address - Zip Code:54661-9312
Mailing Address - Country:US
Mailing Address - Phone:608-534-6391
Mailing Address - Fax:608-534-6392
Practice Address - Street 1:24231 4TH ST
Practice Address - Street 2:
Practice Address - City:TREMPEALEAU
Practice Address - State:WI
Practice Address - Zip Code:54661-9312
Practice Address - Country:US
Practice Address - Phone:608-534-6391
Practice Address - Fax:608-534-6392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-14
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44225700Medicaid