Provider Demographics
NPI:1518154954
Name:PORT WASHINGTON SAUKVILLE SCHOOL DISTRICT
Entity Type:Organization
Organization Name:PORT WASHINGTON SAUKVILLE SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT OF SCHOOLS
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:262-268-6000
Mailing Address - Street 1:100 WEST MONROE STREET
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53074-1217
Mailing Address - Country:US
Mailing Address - Phone:262-268-6079
Mailing Address - Fax:262-284-7742
Practice Address - Street 1:100 WEST MONROE STREET
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:WI
Practice Address - Zip Code:53074-1217
Practice Address - Country:US
Practice Address - Phone:262-268-6079
Practice Address - Fax:262-284-7742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44214300Medicaid