Provider Demographics
NPI:1588838189
Name:EAU CLAIRE AREA SCHOOL DISTRICT
Entity Type:Organization
Organization Name:EAU CLAIRE AREA SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FRED
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISSENBURGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-852-3071
Mailing Address - Street 1:500 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-3770
Mailing Address - Country:US
Mailing Address - Phone:715-852-3070
Mailing Address - Fax:715-852-3066
Practice Address - Street 1:500 MAIN ST
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-3770
Practice Address - Country:US
Practice Address - Phone:715-852-3070
Practice Address - Fax:715-852-3066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44201900Medicaid