Provider Demographics
NPI:1477732907
Name:KAUKAUNA AREA SCHOOL DISTRICT
Entity Type:Organization
Organization Name:KAUKAUNA AREA SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL EDUCATION
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-766-6116
Mailing Address - Street 1:112 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:KAUKAUNA
Mailing Address - State:WI
Mailing Address - Zip Code:54130-2437
Mailing Address - Country:US
Mailing Address - Phone:920-766-6100
Mailing Address - Fax:920-766-6104
Practice Address - Street 1:2601 SULLIVAN AVE
Practice Address - Street 2:
Practice Address - City:KAUKAUNA
Practice Address - State:WI
Practice Address - Zip Code:54130-3564
Practice Address - Country:US
Practice Address - Phone:920-766-6116
Practice Address - Fax:920-766-6122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44201100Medicaid