Provider Demographics
NPI:1497934277
Name:SCHOOL DISTRICT OF COLFAX
Entity Type:Organization
Organization Name:SCHOOL DISTRICT OF COLFAX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISTRICT COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GEISSLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-962-3773
Mailing Address - Street 1:601 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:COLFAX
Mailing Address - State:WI
Mailing Address - Zip Code:54730-9773
Mailing Address - Country:US
Mailing Address - Phone:715-962-3773
Mailing Address - Fax:
Practice Address - Street 1:601 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:COLFAX
Practice Address - State:WI
Practice Address - Zip Code:54730-9773
Practice Address - Country:US
Practice Address - Phone:715-962-3773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44237900Medicaid